AD
Angela D

1 reviews | Active since Mar 2015

08 Feb 2016, 21:53

No Approval for Prescribed Minimum Benefit

My husband had an emergency hospital admission and diagnosis for Hyponatremia SIADH PMB 903K, ICD10 Code E87.1 in December 2014. It took 7 months and a letter to Hello Peter and a threat by him that he would stop taking the medication Discovery deemed unnecessary and would not cover, before he got approval for his PMB . He has re-app**** for 2016. I Emailed the PMB application, fully completed and signed by his endocrinologist, his latest blood test coded E87.1 (confirming hyponatremia- sodium at 130 BECAUSE he is taking salt tablets- normal sodium would be >135) ; new script for salt tablets coded E87.1 AND Discovery Health's OWN APPROVAL LETTER dated 22 July 2015 detailing basket of care for E87.1 for reference. Today my husband was BOMBARDED with 4 consecutive emails REJECTING his PMB application, less than 7 months AFTER you APPROVED it in 2015. Please refer to Jashvir Singh who assisted me via Hello Peter last year. My husband is also a type 1 dabetic and has hypertension - the stress caused by his PMB being declined AGAIN resulted in him having a \ sugar low\" . He has, once again, stopped his salt tablets on your advice. YOU will be responsible when he is hospitalized again. "

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