WM
Wisani M

1 reviews | Active since Jan 2021

29 Nov 2024, 10:14

Key Care authorization nightmare

I am a 41 year old woman who has been struggling to conceive and now I am finally pregnant. Using Key Care, I have activated the pregnancy cover. When I was 13 weeks pregnant I did the prenatal blood tests including the First Trimester Down Syndrome because of my age to determine if I will need the Amniocentesis test. Test results came back and I am on high risk . Discovery rejected the claim from the lab citing that the test is not covered under my plan and one of their consultant could not even explain why the test is not overed. All she did was to read what is written on their website which was not good enough. Discovery is ready to pay for the Amniocentesis but not the tests to determine if I need the test or not. Monday the 25th, my GP submitted a request for authorization for the Amniocentesis, I was advised it takes 3 days to get a respond but today the 29th of November there was still no update or a reply on the request when I called. I am talking about a test that is very sensitive and can only be safely done within a certain period of pregnancy yet we have Discovery sitting with a request and not replying to it. This is the 2nd time i struggle with authorization of something that they say is covered under my plan but always have to fight before it can be granted. To say I am disappointed with be an understatement, given the money that one pays monthly.

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Replies (2)
Discovery Health
Discovery Health's reply29 Nov 2024, 10:50
Official
Dear Wisani M

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
Discovery Health
Discovery Health's reply06 Dec 2024, 16:14
Official
Dear Wisani M

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team