JK
Joyce K

1 reviews | Active since Aug 2016

22 Nov 2024, 16:00

REFUSAL TO PAY FOR MY MEDICAL CARE

Discovery authorised my admission for removal of pilonidal sinus at one of their network hospitals in February this year. I suffered intense pain at the time. Due to the severity of my condition during surgery, the Surgeon performed a scoping procedure that cost R7350 and discovered that there were two sinuses. The surgery took longer and the wound was quite deep. Discovery refused to pay indicating that the procedure was not authorised. After several emails with the consultant from Discovery, I have not received their response to date. The surgeon was willing to provide a report to substantiate the reasoning for the procedure. As a result, my funds have been depleted as early as February.

0
Replies (5)
Discovery Health
Discovery Health's reply25 Nov 2024, 07:43
Official
Dear Joyce K

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 reply27 Nov 2024, 13:26
Official
Dear Joyce K
 
We have been in touch with you to answer your comments.
 
Regards
Discovery Health Servicing Team
Discovery Health
Discovery Health's reply27 Nov 2024, 13:27
Official
Dear Joyce K
 
Please check your emails for feedback from us.
 
Regards
Discovery Health Servicing Team
JK
Joyce K's update09 Dec 2024, 17:48
Reviewer Update
Your feedback contradicts Discovery's initial response to my email after I explained my unprecedented diagnoses which warranted an endoscopic procedure during surgery in theatre.

Given, the Discovery's response below, it was clear that there was no willingness to listen to me or my surgeon's report if need be for the rationale.

"Please note that for the co-payment to be reviewed by the scheme they will require the scope report confirming the diagnosis. Should the condition be regarded as a PMB condition then the co-payment will be reviewed and paid from the risk portion. "
This was followed by my response to your email which Discovery never responded to despite several followups. This is not a co-payment but a refusal to pay a procedure which in your view was not life threatening but a luxury.
Discovery Health
Discovery Health's reply11 Dec 2024, 09:51
Official
Dear Joyce K
 
Please check your emails for feedback from us.
 
Regards
Discovery Health Servicing Team