70yr OLD PENSIONER - BACK OPERATION HAD TO BE CANCELLED 3 TIMES ... NEUROSURGEON AND MIR SCAN CONFIRMS PATIENT REQUIRE SURGERY !! " MEDICAL ADVISOR OF MEDSHIELD DECLINES OPERATION - 1st WEAR INNERSOLES, 2nd REQ PHYSIOTHERAPY???

My Neurosurgeon in UMHLANGA confirmed my diagnosis with my 1st x-rays I req surgery on 2levels - But I had a previous back 5yrs ago so these 2levels had to be tied up with the other 3levels - so Dr has to work on 5 levels - as explained in a motivational letter that was provided. (1st operation - Tues 8/8) MRI, 1st Dr Motivational lett, Procedure codes e-mailed to medical aid 4/8. Monday 7/8 - operation cancelled fitness report req. (Next Operation 10/8) I had to go for the fitness report which my Neurosurgeon had to phone the Cardiologist to fit me in and same day Bone density report was done. Reports e-mailed to medical Thursday 10/8 - again we had to cancel the operation. Thursday afternoon medical aid requires 2nd motivational letter from Neurosurgeon explaining procedure - which was mailed early Friday morning. (Next operation scheduled Tues 15/8) IN THE MEAN TIME MY DAUGTER WHO WAS GOING TO BE WITH ME HAD TO CHANGE LEAVE DATES/ACCOMMODATION DATES!! I HAD TO PAY FOR ALL THESE TESTS THAT WAS REQ BY THE MEDICAL AID - BECAUSE THERE IS NO FUNDS AVAILABLE ON MY DAY TO DAY SAVINGS! WE ALSO LOST THE MONEY PAID FOR ACCOMMODATION FOR THE WEEK! I made numerous calls Monday morning - eventually 12h00 I was told my operation was declined - I WAS REQUESTED BY THE MEDICAL ADVISOR TO WEAR INNERSOLES... Which I told the consultant I have been doing for 3weeks...she went back to the medical advisor with info and return stating THE MEDICAL ADVISOR STILL DECLINES MY OPERATION - STATING I MUST GO FOR PHYSIOTHERAPY AND A 2nd OPINION... SO WHERE DOES THIS LEAVE ME??? A 70yr OLD PENSIONER IN SO MUCH PAIN, CAN HARDLY WALK, EXAMINED BY A NEUROSURGEON BUT REQUIRES PHYSIOTHERAPY??? I reported it to MEDSHIELD COMPLAINTS DEPT- 2days later again OPERATION DECLINED REQ PHYSIO!! I decided to log an complaint at the Medical Board - which they confirmed I do have a case (complaint no 65901 - dated 16/8)...but the medical aid has a month to reply and who's to say they are going to AUTH my operation... But the reason why I am writing this on Hello Peter... Monday another patients operation was declined, unfortunately I got to hear of this. THIS PATIENT ALSO MEDSHIELD - ELDERLY LADY ASWELL - ITS IS HER 1st OPERATION DR HAS TO WORK ON 2LEVELS AND SHE HAD GONE PHYSIOTHERAPY ALREADY! SO WHAT I WANT TO KNOW, ON WHAT PROTOCOL DOES THIS MEDICAL ADVISOR AUTHORIZE AN OPERATION??? This member had Physio, must be operated on 2levels and her operation gets declined "old Lady" ??? As they discussed with me they will only pay 2levels once I went for Physio??? WE ARE BOTH PENSIONERS IN A LOT OF PAIN! I WOULD WANT THIS MEDICAL ADVISOR TO BE INVESTIGATED? I AM LOGGING THIS COMPLAINT BECAUSE I AM SURE THERE ARE MORE PEOPLE OUT THER BEING TREATED THIS WAY - WHERE THIS ONE PERSON MEDICAL ADVISOR DECIDES AND GOES ABOVE THE DIAGNOSIS CONFIRMED BY SURGEONS/SPECIALISTS (x-rays MRI) - NOT TAKING IN CONSIDERATION THE AGE, PAIN, DISCOMFORT NOR HEALTH ISSUES ONE HAS TO GO THROUGH!