Left hand as *********** as the right hand

<p>On the 14th March my son's doctor sent the medical Aid a authorization request to ********** ,this was received, nothing was done with regards to the request. On Friday 25th 2017 I enquired as to the status and was told nothing was on the system,we were then told to tell the Dr to re-send all information to a alternate address as the address has changed to ********** We booked the operation on the 14th March for the 28th March 2017 knowing that medshield needed time to process the authorization.<br /> <br />On Friday 25th 2017 we booked the operation for the 28th the booking status pending as the needed more motivation documents from the doctor this was sent on Monday following. On Monday it was referred to a medical advisor. The medical advisor denied the procedure because he could not find the code on the PMB list, the codes used by the doctor for this operation were the same as the previous operation on 3 September 2015. The medical advisors response was denied due to specific condition. Numerous attempts from 27th March 2017 to today 30th March 2017 was made by myself and the doctor to provide clarity as to which codes he is referring to and making it possible to provide the necessary documentation for authorization.<br /> The operation was declined on the basis that this code was not PMB codes for my plan will only exept PMB codes. </p> <p>On the 10 April 2017 I received a e-mail from Medshield stating the following:</p> <p>Kindly be advised that the case was initially declined due to as per benefit guide Prosthesis on Medivalue option is limited to PMB only. Based on the treatment now according to the provider it is not a PMB related. We have escalated the complaint to authorisation manager to relook in to the case and i will revert back or she will be in contact with yourself with regards to your complaint.</p> <p>As to date I have heard nothing.</p> <p>The doctor then once again sent a request to medshield for authorization after receiving their correspondence to use a different code, this was done on Thusday 18 April 2017 for operation 3 May 2017. Once again we had to follow up just to be back at square one . The doctor then tried to speak to the Medical Advisor in order to hear what is wrong, he held on for 45minutes getting sent from pillar to post by one rude and obnoctious person to the next, and then eventually after getting the advisors number he does not answer his phone. Once again the operation has to be posponed, because their is nobody one can actually talk to that knows what they are doing.</p> <p>My son needs this operation for the following very important reason: If he falls it can be fatal. This operation is is the next step after the operation in September 2015 and is related to the same accident of scaffolding collapsing on him and breaking his neck it has nothing to do with prostesis as the plate already in his neck gets taken out a bigger put in and another added. The sadest ever is that Medshield is basically insured of getting their monies back from the building company.</p>