TH
Themba H

1 reviews | Active since Jul 2014

03 Apr 2015, 07:59

High Dose

Tried to purchase allergy tablets at clicks pharmacy, purchase was rejected reason given high dose. High dose means the purchase can only be accepted once the duration of previous prescription is finished, which makes sense but interestingly, this was going to be my first time this year buying the medication, last purchase was late last year, why high dose then?, no satisfactory explanation given except that the whole situation can only be solved on the 7th of April, that means I must survive 6 days without medication whereas one day of defaulting payment of medical aid, the account is deactivated. Apparently there is a ban that needs to be uplifted and that can only be done after 6 days. For the high amount of money that I pay, for the less times I use the medical aid, this is the worst disgusting service ever and it's about time I move to another medical aid. I guess it's better to have an average medical aid rather than have a medical aid that prides itself as being the best whereas clients are treated like dirt. The likely response will be we regret the inconvenience and we investigating to make sure this doesn't happen again, save your apology, just cancel my membership.

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Replies (1)
Discovery Health
Discovery Health's reply07 Apr 2015, 12:09
Official
Hello Perla del Sur,

Thank you for your comment

I have investigated the claim received and found that the rejection was correct. Please allow me to provide context to my statement.

The Scheme uses the manufacturer's guidelines for safe claiming patterns for medication. The manufacturer confirmed that you can safely use 1 tablet per day for adults. The claim we received dated 2015/04/02 from the pharmacy was for 30 tablets over 10 days of therapy. This means that the patient was to take 3 tablets a day and therefore the claim rejected with a reason code: 633 - We have not paid this amount as the maximum dosage allowable has been exceeded for this patient.

If the medication was to be taken one tablet a day, please ask the pharmacy to claim the medication correctly, with 30 days of therapy instead of 10.

I trust that you find the information above, useful.

Kind regards
Danita

Best regards,