*********** staff or system error????!!!!!!

<p>My Wife and I had triplets on the 17/02/2017 after she had to be admitted the evening before due to pain. They were born on 25 weeks and not in the best of health but we did the pre-authorisation with the medical aid well before the time and everything was approved. We put them on the medical aid as soon as we could and then the problems started. We checked on the medical aid internet profile and noticed that the bills that should have been coming off the hospital benefit was being paid out of the MSA, now the MSA is depleted, obviously and we are starting to receive bills from services that is being conducted IN hospital because that is where they still are, in the NICU ward IN HOSPITAL.</p> <p>Money was even paid into my wife's bank account for 70% payment to a service provider on a code 70, meaning 48 hours was not given for authorisation, really, they are new-borns and birth was pre-approved, it's not like they didn't know. The money is still sitting in her bank account waiting for it to be reversed and proper payment to be made to the service provider on the hospital benefit.</p> <p>We contacted the medical aid and they reprocessed some of the claims, paying it out of the hospital benefit and refunding the money back to our MSA, fine enough, we were happy about that but then it happened again. Then after numerous calls to the medical aid to have the same problems rectified and speaking to different consultants every time having to explain everything over and over again (tiring, right?) we finally came to the root of the problem.</p> <p>According to the discovery consultants, the hospital (N1 City Hospital) are not updating the authorisations of the triplets being in hospital on a regular basis, causing their system to pay the service providers "out of hospital", meaning from our MSA and if the MSA is depleted, we get the accounts.</p> <p>So on a visit to the babies we queried this with the hospital and more specifically the case worker, Marie-Lu. She assured us that she regularly updates their authorisations and even gave us the dates. With this new information we called discovery again and again but they could not pick up these authorisations, so we are sitting with the same problem which logically can only mean that the authorisations isn't loaded timeously or somebody is *********** at their job but there clearly is an information transfer black hole that needs to be identified and rectified. As things stand our MSA is still depleted, we are expecting more unpaid bills, and more wasted airtime in phoning them for the same things and more importantly more unneeded stress on top of worrying about our babies.</p> <p>On the claims transaction history pages there are a lot of codes, 274, 70, 268 and now 133. We wish the entire "miscommunication" can just be sorted out so that our full attention can be spent on our triplets.</p> <p>Get your act together discovery, you are the leader in the medical aid industry but you fail miserably at taking corrective and preventive action and we are getting frustrated at having to do the same song and dance OVER and OVER!!!</p>