CO
Corne O

1 reviews | Active since Jul 2017

15 Jul 2017, 10:44

KIDS CASUALTY NETWORK MYTH

<p>Don't be fooled. There is really a better chance to see the a<br />Abominable Snowman than to make use of the OUT OF MSA KIDS CASUALTY BENEFIT on a Classic Saver account.</p> <p>I am not the first to fall for this, (see previous complaints) but I genuinely believed that I had this cover. After all, on their Scheme rules for 2017 it states that a child under 10 gets two casualty visits per year once MSA is used up.</p> <p>AND on the rules registered with REGISTRAR of MEDICAL AIDS it says that 2 visits per year at a IN NETWORK hospital is covered.</p> <p>Now, here comes the problem. Classic Saver is not limited to any hospitals and hence no CLASSIC SAVER NETWORK HOSPITAL LIST. And besides the hospital I went to is a Smart Network Hospital which is a lower account.</p> <p>But because it is not on CLASSIC NETWORK LIST cover is not offered. But hello, there is no list.</p> <p>But then I get referred to Kids CasualtyNetwork on MapS app.</p> <p>But there is no Kids Casualty reference or option on Maps.</p> <p>Then to make matters worse you need to ensure GP who is on call that night is on Kids Casualty network. So double whammy.</p> <p>My question to them the last 3 month have been how to find a Kids Casualty Network and or GP.</p> <p>And then I get referred back to MapS app.</p> <p>And then the cycle repeats.</p> <p>Problem is that consultants read only first line of email then reply with exactly the same nonsense that I asked them to clairify.</p> <p>Unless it is a computer bot and not a real person replying- which would make more sense.</p> <p>And alas even if you do establish, as I did, that Midstream Mediclinic is on Kids Casualty network, then the wrong code was used. Then when code is fixed on invoice the cycle repeats because it is now Tuesday and Midstream Mediclinic is suddenly not on KIDS CASUALTY NETWORK anymore and I get referred back to MapS tool.</p> <p>So, Discovery Health either does not know they offer cover or the cover does not exist. Even though they registered it with REGISTRAR.</p> <p>And good luck to you if you ever in fact need to use the cover - that you thought you had - when you rush to a CASUALTY Unit near you at 2am in morning.</p> <p>So, for those of you on Classic saver, rather go and explore Crop Circles because you might just see the Yeti there.</p> <p> </p> <p> </p>

0
Replies (6)
Discovery Health
Discovery Health's reply17 Jul 2017, 09:18
Official

Dear Corneober1

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 reply18 Jul 2017, 14:49
Official

Dear Corneober1

Please check your email inbox for our final feedback.

Regards
Discovery Health Servicing Team

CO
Corne O's update04 Sept 2017, 12:16
Reviewer Update
After months of emails and arguments Discovery made a "rule exception" and paid me for hospital part of visit. Claims rejected because hospital did not use correct code nor were they able to use such a code. Anyone previously rejected for Kids Casualty benefit should contact their hospital and attempt claim through them as they can best explain their position to Discovery. It is regrettable that getting this claim partly resolved so far was so difficult and will probably remain difficult because very few people at Discovery know of or understand how this OUT of MSA benefit works and or how to help you claim for it. Also getting information about which hospital and doctor to use is incredibly difficult due information only available via TELEPHONE and not on website as promised. It took me 28 minutes to find a GP on Kids Casualty network over the telephone with consultant.
CO
Corne O's update04 Sept 2017, 12:16
Reviewer Update
After months of emails and arguments Discovery made a "rule exception" and paid me for hospital part of visit. Claims rejected because hospital did not use correct code nor were they able to use such a code. Anyone previously rejected for Kids Casualty benefit should contact their hospital and attempt claim through them as they can best explain their position to Discovery. It is regrettable that getting this claim partly resolved so far was so difficult and will probably remain difficult because very few people at Discovery know of or understand how this OUT of MSA benefit works and or how to help you claim for it. Also getting information about which hospital and doctor to use is incredibly difficult due information only available via TELEPHONE and not on website as promised. It took me 28 minutes to find a GP on Kids Casualty network over the telephone with consultant.
Discovery Health
Discovery Health's reply04 Sept 2017, 13:03
Official

Dear Corneober1

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 Sept 2017, 13:51
Official

Dear Corneober1

Please check your email inbox for our final feedback.

Regards
Discovery Health Servicing Team