Shocking Service!!!! - Discovery Health

I’d like to express my utmost shock at Discovery’s appalling admission authorization process that I was unfortunately victim of when I had to be admitted at the Durdoc Hospital on Wednesday 18/09/2019.

Firstly, when the hospital admissions guy made the call, he was told that we must wait for 2 hours for the request to go through to the Case Manager for approval/authorization. That took me by surprise because it was the first time I experienced it, but I said it’s fine I’ll go home & get all my toiletries and all the necessities for hospital admission & come back, while we wait for these 2 hours, mind you at the time I was very weak. I then left to go home. On my way home, I was called by the Hospital admissions guy and he told me that Discovery wanted me to do all the tests & bloods ordered by the Dr as an outpatient and they were not going to authorize my admission.

I had to return, and when I got there, the Case Manager was insisting, that she was declining my admission and when the hospital called the Dr, he said he was not prepared to run tests and treat me as an outpatient, they(Discovery) must send something to me as a patient in writing stating their reasons for the decline. The admin guy got me to speak to the Case Manager, who I must say was not making any sense as she told me that I was supposed to have gone to the GP first and got these tests done; that made no sense because firstly, I had gone to 2 GP’s and got no joy prior to this, hence I went to the Specialist Physician, secondly she said I should have taken these bloods during the GP’s visits and told me that every time I go to the GP I must do that, to avoid this issue from happening again… WHAT *******????? Since when does the patient dictate to the Dr what tests the Dr must run? And besides, if every time I go to the GP, I get bloods done, as she suggested; what’s that going to do to my Medical Savings??

I told her I’m not interested in this inpatient/outpatient nonsense & jargon she’s telling me about, all I know is that I’m very sick and I pay a lot of money for Medical Aid and I needed to be attended to. She eventually said she’ll remove the Decline status and authorize my admission for 24 Hours only, and this authorization would only be for 1 symptom that she asked me about and not for anything else, which meant that Discovery wouldn’t cover any other ailments under this authorization that are not related to this specific symptom. She further indicated that anything outside the 24Hours, will be to my own account, unless if the Dr picked up something that was abnormal from the tests they authorized.

I could hardly breathe when this was happening and had to use the little amount of energy & breath that I had, to fight for Discovery to admit me. There I was at the hospital admission area, fighting & begging with the last energy I had, a very sick client of theirs, who has been a member UNINTERRUPTEDLY for 9 YEARS, a member who barely uses the hospital benefit and the one of the very few times that I needed this benefit that I pay for diligently, every month & every year; getting them to admit me was like pulling teeth!!!!

I was VERY disappointed and appalled by the treatment & service I received from Discovery, and this experience really made me realize that Discovery doesn’t have their clients’ best interest at heart, I could have been dying and needed immediate attention while they were busy interrogating me about why I never went to the GP first & why I never got the these tests done by the GP, why does that even still matter?? All that matters now is that I’m here and I must be treated from the benefit that I’ve been paying for. So what does it mean when they say Unlimited Hospital Benefit, if I’m gonna be sent to hell & back before I can use the benefit??

I’m XTREMELY unhappy & disappointed, I’ll never recommend Discovery to anyone that I care about and I’ll be definitely researching other Medical Aid providers that I can move to, and where I can get value for my money. The case manger's name was Sumesh / Sunesh