MO
Morne O

1 reviews | Active since Nov 2015

23 Nov 2015, 14:35

PMA submitted 2 weeks prior and still no feedback

Received authorization for hospitalization 27th Oct<br> First claim went through on authorization, however all subsequent claims relating to the hospitalization have been put through either MSA or declined.<br> Doctor supp**** PMA as requested on the 9th Nov with all relevant information required, the doctor was contacted on numerous occasions to the point that he felt harassed Discovery.<br> However no one informed me that they had any problems on the back end.<br> I have called over 7 times, many occasions even on the same day. I am getting different dates of communication every time I call. I have just gotten off a call and yet again I cant be updated with any information, they now have no notes on my PMA and will have to call in their forensic department to look into this. I have been with Discovery since September this year and lets just say they aren't off to a good start... So far this is one of the worst customer relations I have ever seen!!! It has now almost been a month since my hospitalization and most of the bills are due.... Who will be the one getting the bad credit record due to Discovery Health's incompetence???<br>

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Replies (1)
Discovery Health
Discovery Health's reply25 Nov 2015, 12:55
Official
Hello Morneoli,

Thank you for your comment.

When a member joins the Scheme, we process the application according to the information disclosed on the application. Once the membership is activated and we receive a request for either in or out of hospital authorisation within a certain period of time our system will automatically pend the request. We will then request further clinical information from the treating provider. This process is necessary to ascertain whether there were any pre-existing conditions of which we were not aware. Please accept my sincerest apologies that your query was not attended to timeously.

We confirmed that the Standards Team has been in contact and provided feedback.

Regards
Discovery Health Services