LJ
Lindsay J

1 reviews | Active since Nov 2013

29 May 2026, 09:58

Epic fail by Flexicare (powered by Discovery)

I was referred by my GP to have an Ultrasound on my bladder on 11 May 2026 and Lake Smit & Partners at Parklands Hospital in Durban were my chosen radiographers. I was assured by my GP, after checking whilst I was sitting in his consulting rooms discussing the procedure, that I'm entitled to one ultrasound per annum. He completed the relevant form and his receptionist emailed it to Lake Smit. During the bladder procedure, the radiographer detected a large ovarian cyst on the left ovary that needs gynae intervention. I cannot afford medical aid as I am semi retired and was recently widowed. Funds are therefore very tight! I have since received a rejection notice from Flexicare to say that the cost of the ultrasound is for my own account as the one procedure which is related to the dreaded code, is not covered by Flexicare and I am therefore responsible for paying R1011.30 to Lake Smit & Partners. Unfortunately Lake Smith & Partners mentioned pelvic area in their report and this is apparently the reason for my claim being repudiated. No-one knew that there was a separate code for a pelvic area ultrasound or my GP would've taken that into consideration and the radiographer was just doing her job! I do not think it is fair or ethical for me to be responsible for this account as I am not one of those people who is happy to have the wool pulled over their eyes and accept this epic fail on the part of Flexicare (Discovery). Between Flexicare and Lake Smit there has been a misunderstanding as to what procedures were carried out and I am the scapegoat!

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Replies (1)
Flexicare
Flexicare's reply29 May 2026, 15:12
Official
Dear Lindsay
 
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. Regards Flexicare Servicing Team

Best regards,