No Care attitude concerning Kidney Failure patient

<p>My name is Mr J du Plessis membership nr: ********** 50</p> <p>I am listing a complaint on your Facebook page and on Hello Peter in a last ditch effort to get assistance with some payments for treatment of my wife’s condition. All my efforts to resolve the matter with your call centre has failed.</p> <p>My wife has Diabetes and Chronic Renal Failure and has to be listed to receive a Kidney and Pancreas Transplant.</p> <p>On 19-09-2016 she had to go see a Dr Britz who is as far as I understand is the only vascular surgeon we can see if we want her to receive a new Kidney. We were directed to go and see Dr Britz by our transplant coordinator. He had to assess the condition of her vascular system so as to determine whether or not she is fit for transplant.</p> <p> As far as I understand this is a condition that is to be covered under prescribed minimum benefit by Law.</p> <p>The appointment and procedures the doctor had to complete was claimed from Discovery, It was a charge of Around R5000 but only R357.60 was paid. When I queried this I was informed that the doctor in question had no payment arrangement with discovery and was therefore only paid at the discovery rate.</p> <p>I then proceeded to ask to be referred to a suitable Dr that has a payment arrangement with Discovery but according to your consultant there is none in the Johannesburg area.</p> <p>I pay my medical aid faithfully; every month close to a quarter of my salary goes to discovery, cover I obtained for a time such as this. My wife is in need of a kidney transplant and can only be assisted by the Dr in question; we cannot afford the fees charged which is exactly why we have medical aid. Discovery has no alternative physician that they have an arrangement with that we can consult, how can you then not cover the charges.</p> <p>I have phoned your call centre multiple times and it took 2 months just to get the payment of R357.60 released.</p> <p>Each time I call it takes between 30-60 minutes to get some kind of answer. I have been promised on more than 1 occasion that I would get feedback and then never hear from you again. I have had to jump through administrative hoops by getting Dr’s to fill out PMB application forms and then motivate it which sometimes takes weeks. Our specialist has gotten to a point where he is unwilling to assist us with motivational letters any further because Discovery keep sighting some insufficiency in the letters he writes.</p> <p>We have had to have bloodtests done to determine my wife’s tissue type so she can be matched with a donor the cost of which came to roughly R4000,discovery paid less than half. When I phone to find out why ,the answer is simply that it is not part of your basket of care!!!</p> <p>My wife has to endure daily discomfort because of this disease and could possibly die from it. Our transplant coordinator tells us that the tests have to be done and were quoted for when they sent in the submission for my wife’s transplant. Yet it seems discovery is unwilling to cover what is needed.</p> <p>From my point of view it seems that discovery is only in the business of taking my money and then not delivering on their promises when I have the direst need.</p> <p>What is worse is that if I understand correctly the government requires that my wife’s condition be covered in full.</p> <p>Can someone please assist. If I receive no response from this complaint I will be lodging a complaint with the medical council of South Africa to have this investigated further.</p>