1 reviews | Active since Jun 2018
Required COVID-19 Screening Not Paid by Discovery
A week ago, I was rushed to the hospital with severe kidney pain. It was determined that I had a kidney stone and was to be admitted immediately for an emergency procedure. However, prior to being admitted, you must undergo a COVID-19 screening test (no choice or the hospital refuses to admit you). Anyway, I had the test done, I was admitted, and the procedure was conducted. I was however to return a week later to have the actual stone removed. This required authorisation from Discovery as I have a hospital plan. I contacted Discovery and obtained authorisation as per the norm. The only change was that I had to undergo another COVID-19 test 4 days prior to being admitted. This was a prerequisite from the hospital (although is was only 5 days since my last COVID-19 test). The only reason for the test to be conducted 4 days before being admitted was to ensure that results were available for the hospital. Again, it was made noticeably clear that if the test was not conducted or the results were not available at the time of being admitted that my admission and operation would be denied. Again, the test was conducted, and I again received a negative reading. I was admitted and the procedure was conducted. At this time, I received my first invoice from Path Care that my COVID-19 test must be paid within 7 days. I then spoke to the surgent and the hospital admin – in both instances they said this issue is with Discovery. Apparently, all parties involved are aware of the hospital’s prerequisite is to have a test conducted. It astounds me that in this scenario Discovery refuses to pay the COVID-19 claim. At no point throughout the process was it communicated to me that the screening is not covered by my Discovery hospital plan. How hard would it have been to let us all know that NO COVID-19 testing under any circumstances would NOT be covered. Surely due to it being a prerequisite to admission, it should be covered. Unnecessary and un-budgeted costs in these times are not welcomed!
Regards
Regards
Regards
Regards
"We did not fund the above claim for R 850.00 because you are on the Coastal Core Plan and you do not have a Medical Savings Account (MSA). You are liable for this amount. "
I am well aware that I only have a hospital plan, as specified in the review. All I am asking is fair expectation. I elected this particular plan with the expectation that hospital costs are covered - the very purpose of the plan. An expectation that would appear to be unreasonable.
"We did not fund the above claim for R 850.00 because you are on the Coastal Core Plan and you do not have a Medical Savings Account (MSA). You are liable for this amount. "
I am well aware that I only have a hospital plan, as specified in the review. All I am asking is fair expectation. I elected this particular plan with the expectation that hospital costs are covered - the very purpose of the plan. An expectation that would appear to be unreasonable.
