DR'S MEMO GETS REJECTED - IS THE DECIDING CONSULTANT A DR?

I have a complaint.

I am sending this email to Medihelp first in an attempt to get this resolved, if no response is received, i will be making an official complaint on Helopeter and with the Medical Ombudsman. (I GAVE THEM THE OPPORTUNITY TO RESPOND, OF WHICH THEY IGNORED)

Long story short :

I have been in great medical condition. Children born in 2006 & 2009. I had breast reconstruction surgery in 2012 (AT MY OWN COST) due to extreme elastic skin due to breastfeeding. Everything went well. In 2017 I had another baby which was not planned. In 2018 i realized some bumps in my breasts and again the elastic skin issue was a concern. I went back to the same DR who performed the first reconstructive surgery as he was fami**** with my situation. On day of consultation the DR analyzed the situation and recommended that we again do reconstructive surgery, of which i was prepared for, and would be on my own account. Once i wanted to get up from the bed, he noticed my stomach, and asked if he could have a look at it, i agreed. He confirmed that i had a hernia, and my stomach muscles were completely separated, he suggested that i go for a sonar for my breast bumps and for my stomach, to confirm. I went for the sonar, which confirmed the hernia and the muscles that are separated. I sent the sonars to the DR, and the DR confirmed that the will be able to do the procedures. I was still paying for my reconstructive surgery on my own, there was never a intention of claiming it from the medical aid, so the medical aid had no right to ask if i am doing that, as i can prove that i am paying for the entire process myself. The DR suggested that the procedure for my stomach can be claimed. I sent all the necessary info to Medihelp, and they requested more sonars, more letters, more info, of which was already sent to them. My request was not approved as requested, as the staff at Medihelp is under the impression that i will be receiving a "tummy tuck" of which is not the case, and this was confirmed by the DR with a letter to Medihelp, but still it was not approved.

My issue is as follows, this DR (not his fault he is a plastic surgeon) noticed something that i did not go to him for, he suggested a cut at the bottom of my stomach and not in the middle of my stomach, of which both cuts will do exactly the same but will not look like you were butchered, which i agreed, and respected, and believe that i am entitled to......now somebody just employed with Medihelp, with who knows what knowledge, this person is not a DR, Surgeon or Nurse, decides that the procedure may not be approved, because the DR whom noticed it, is a plastic surgeon and because he wants to cut at a different place than what other DR's would have..........insinuating a "tummy tuck", and i MUST have the cut in the middle!

I disagree, i have been paying my medical aid, with no issue, and this procedure was not intentional, but should be addressed, as it is getting worse, and why do i need to go to another DR for the same procedure, of which this DR is already fami**** with and CAN do it, same as any other DR.

It is not for Medihelp to decide if i need it to be fixed or not, they are not DR's, and the DR gave a full description of his intentions!

I DO NOT need a "tummy tuck"!

My weight is around 65/66kg, i am not fat! And I did not choose to have a hernia or separated muscles, but i have have it, i also made sure i have a medical aid, for if i need it, now they just refuse to help you based on speculation.

Requesting that you decision be reassessed, or i will be forced to take an alternative route.

Hoping that i will be hearing from you soonest.