The treatment a Key Care Plus patient can expect from a Provider linked to the network.

Dear Discovery

I am writing to express my deep concern and dissatisfaction regarding my recent experience at RP Parsotam Optometrist in Queensburgh. As a Key Care Plus Discovery medical aid patient member nr ***, I feel it is important to bring this matter to your attention for further investigation and resolution. Prior to my appointment, I contacted the practice to confirm that they accepted Key Care Plus and charged according to the Key Care Packages. However, during my visit, I was shocked to discover that my bill amounted to approximately R3,900 for scripted lenses (with no add-ons) and the consultation, my father gave me for Christmas a frame to use. Out of this amount, I was informed that I am liable for approximately R1,900. When I requested a detailed printout of the charges, this request was denied. Furthermore, when I inquired why I was not being billed according to the Key Care Plus rates, I did not receive a satisfactory explanation and I was left deeply embarrased. To provide some context, during my previous consultation two years ago, I paid an additional amount for Blue Block tinting as I spend extended periods on the computer, and the glare affects my eyes. However, after consulting with Spec Savers a few months ago, I was informed that the tint does not efficiently block computer rays. For this reason, I did not request this add-on for my new lenses. Despite this, I also noticed a charge of approximately R1,340 for contact lenses on my card previously dispensed to me. When I queried this with the staff member, she became defensive, leaving me feeling embarrassed and uncomfortable. My aunt, who was accompanying me, stepped in to assist, but the situation escalated further. The owner of the practice then approached my aunt and stated that "this is what it costs for scripted lenses," and he does not need to explain why he is not charging Key Care Plus rates. He further mentioned that his charges are not answerable to Discovery and suggested that my aunt take the script and leave. My aunt was left in shock and deeply embarrassed by this interaction. Given my current financial situation and unemployment, my father pays for my Key Care Plus Discovery medical aid. I always ensure that I inform practices of my need to be billed according to the Key Care Plus package. After returning home, my aunt contacted another Key Care Plus provider, who informed her that once the consultation is charged to medical aid outside of the Key Care Package, the package becomes null and void for use at any other Key Care Plus optometrist. My aunt immediately messaged RP Parsotam Optometrist, requesting that they do not charge the consultation to medical aid and that she would pay the R700 consultation fee in cash. However, when she arrived at the practice the following Monday morning to pay, she was informed by the staff member that paying cash was not an option and that the consultation fee would be charged to medical aid regardless of our request. This lack of flexibility and understanding left us feeling frustrated and helpless.

My aunt then contacted Discovery's Optometric Department and spoke with Lerato, who provided exceptional assistance. Lerato confirmed that contact lenses, which were never dispensed, had indeed been charged to my medical aid. She assured us that Discovery would follow up with the practice regarding this matter. Lerato also informed us that if the R700 consultation fee was paid in cash, the practice could reverse the charge to the medical aid, allowing me to use my Key Care Plus package at another optometrist. My aunt immediately returned to RP Parsotam Optometrist and paid the consultation fee in cash. We are now awaiting feedback from Discovery regarding the investigation into the contact lenses that were charged but never dispensed. This entire experience has left both my aunt and me feeling embarrassed, shocked, and disheartened by the lengths the owner of the practice went to secure payment, seemingly at the expense of ethical and professional standards.

I kindly request that this matter be thoroughly investigated and appropriate action taken to ensure that no other patient has to endure such an ordeal. I also hope to receive updates regarding the investigation into the contact lens charges and confirmation that my Key Care Plus package remains valid for use at another provider.

Thank you for your attention to this matter. I look forward to your response.

Kind regards,