WM
Wenzile M

1 reviews | Active since Mar 2016

15 Mar 2024, 16:42

Non-payment of authorized treatment which authorization was granted to the hospital

A treatment was performed on 04 March 2024 at a hospital in Sandton. Despite the treatment being pre-authorized by Discovery Medical Aid, they did not communicate the authorization details to me, the policyholder, leading to undue financial strain and inconvenience. The authorization for the treatment was effectively communicated to the treating hospital, who conveyed to me that they had authorization. Consequently, I was entirely unaware of the authorization status (any excluded payments) and assumed, reasonably, that the hospital had successfully obtained approval from Discovery Medical Aid.

Discovery has now attempted to send me the authorization letter and it is dated 15 March 2024 for a procedure performed on 04 March 2024.

Discovery's failure to communicate to me what they had authorized let to us being faced with a payment debt of R24,488.30 which they are refusing to refund us.

We want our refund, we cannot be victims of Discovery's own oversight.

0
Replies (2)
Discovery Health
Discovery Health's reply18 Mar 2024, 07:13
Official
Dear Wenzile 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 reply19 Mar 2024, 12:35
Official
Dear Wenzile M

We’ve contacted you regarding your complaint. 

Regards 
Discovery Health Servicing Team