Hospital Claim

I am requesting clarity and assistance regarding my iron infusion claim with Discovery Health that did not pay while in hospital and is currently rejected due to lack of clinical information and my blood test results. I was told dr Solomon that he has sent this information to Netcare discovery case manager Vive and today I went to her face to face and she apparently resigned and no one can help. I’ve contacted discovery many times and no one can find the information and documents that was sent The infusion was administered while I was hospitalised based on my treating doctor’s clinical assessment that it was medically necessary. My iron studies at the time reflected: Serum iron below the reference range Transferrin below the reference range Transferrin saturation below the reference range Ferritin level of 260 I have also been on prolonged oral iron therapy for several months, including Ferrovave and Sidal Forte without adequate improvement in my iron levels. This morning, I approached Viwe, the Discovery clinical case manager based at Netcare Greenacres Hospital. She attempted to assist me and informed me that the usual ferritin reference threshold for approval is below 100 and that this appears to be the only criterion I have not met. She indicated that she would review the matter further. However I was later informed that she has resigned and I have not received any feedback or guidance on who will now be handling my case. I am uncertain who to approach at this stage and this has become increasingly frustrating as I am actively trying to resolve the matter appropriately. I would like to emphasise that an elevated ferritin level does not necessarily exclude iron deficiency particularly where serum iron, transferrin, and transferrin saturation remain below the reference range. My overall iron profile has consistently demonstrated low iron parameters despite prolonged oral therapy. There was also a period where my ferritin levels were low. If required I am willing to submit cumulative historical blood results to demonstrate the persistent pattern of low serum iron, transferrin, and saturation over time. I respectfully request confirmation of: 1 Who is now responsible for reviewing my case. 2 Whether my full iron profile and treatment history will be assessed holistically. 3 The appropriate next steps to ensure this matter is properly reviewed and an email