1 reviews | Active since Jan 2015
False misleading advertising .
I am a discovery key care plus member. I have had persistent pain in my shoulder. I went to see my registered discovery GP she referred me to a orthopedic specialist who sent me for a sonar,MRI & X Ray. These scans confirmed that there is a tear in my tendon the specialist referred me to a orthopedic surgeon to do a arthroscopic operation and repair the tear. I received authorization for the consultation with the orthopedic surgeon before the operation. During the entire process I followed the discovery prescribed route to the letter. I also corresponded with my discovery broker to ensure that everything would be covered when it came to the operation. She sent me an email highlighting a section of the discovery key care brochure that specifically mentioned the shoulder operation I have to do. After receiving confirmation from my discovery broker that the process is covered I continued to make arrangements for the operation . After authorization for the consultation with the orthopedic surgeon I phoned discovery to obtain authorization for the surgical procedure the next day. My Authorization was declined on the bases that the procedure is not covered by key care, I referred the call center agent to the key care brochure page 11 which specifically indicates the operation I have to undergo is covered. It took the call center agent 20 minutes to find a answer to my question. At first he mentioned that it might have been a mis-print after calling his supervisor they noticed an asterisks next to orthopedic procedures which referred to a foot note that referred to a different page (page 33) which mentioned that shoulder & knee operations are not covered in the key care plan. Surely you can not print a brochure for a specific health plan ( it says key care series on the front page) that includes and excludes the same procedure. The procedures on page 11 of the brochure was explained and specifically mentioned to me before I enrolled with discovery. This was used as marketing and successfully convinced me to join discovery but when it comes down to owning up to it fine print is used to indemnify discovery from covering my surgery . Fine print so well hidden it was both missed by a discovery broker and a discovery center call agent and his supervisor. I feel that the fact that it was used as marketing specifically mentioned as covered during the process and then declined is wrong discovery should own up to the promises they make or start marketing there products correctly.
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.
Regards
Discovery Health Servicing Team
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.
Regards
Discovery Health Servicing Team
We have been in touch to answer your comments.
Regards
Discovery Health Servicing Team
We have been in touch to answer your comments.
Regards
Discovery Health Servicing Team
