Hospital horror story

The medical aid authorised my hospital stay from the 14th for a 24-hour period. They advised that if I needed to stay longer, the hospital could request an extension. The hospital did request an extension until the 18th, and they were paid.

However, there are tests and procedures from the 16th to the 18th that were not paid because Dr Hargey did not submit his tests and findings. He never submitted the reasons why I was kept in hospital. He ran all these tests, blood tests, and procedures, but never submitted why they were done. As a result, the medical aid declined to pay because they felt the tests could have been done out of hospital.

Dr Hargey submitted a claim for the 14th, but he never saw me on that day.

He saw me briefly on the 15th. He asked what was wrong, and while I was talking, he walked away. I had to call him back to ask what the MRI results were. He told me there were no signs of stroke, cancer, or anything life-threatening, and then walked away again. I had to call him back a second time to ask what would happen next. He simply said I would have a lumbar puncture the next day and then left.

He came back the next day. The nurse prepared me for the lumbar puncture while the doctor was with other patients.

This is the information the medical aid wants. They want to know what the doctor did to diagnose me with IIH, what tests were performed, and what the results were. It has been over a month, and he refuses to provide the information.

On the 16th, the doctor came to me, told me my diagnosis was IIH, and walked away without explaining what it was, what I should do, or how it would be treated. I had to call him back, and eventually I had to Google IIH myself.

On the 17th, he came again and sent me to the eye doctor, but he did not show any concern about the fact that I could not walk or stand properly.

On the 18th, I was discharged. DR HArgey had logged claims for mino stroke which was not discussed as my diagnosis so thats *****

I also had to call several times for medical certificates and medication.

When I noticed that the PathCare claims and some other in-hospital treatment claims had not been paid, I called Discovery. They told me they needed more information from Melomed. I then called Melomed and spoke to Isadoor, who sent files through. I called the medical aid again, and they advised that they needed more results, especially from the treating doctor.

I called the doctor's rooms and was told by his receptionist that he does administration every Thursday. I called again on the Friday and was told that the doctor would send the information, but he still has not done so.

I then called Melomed. A case worker from the hospital was assigned to me and was supposed to contact me. Natasha never contacted me. When I called the hospital and explained that the medical aid required specific information from them in order to reassess the claims, she told me they had already sent everything.

I asked her exactly what had been sent so I could confirm whether the opening pressure reading from the lumbar puncture was included. She laughed and said she had sent all the information. When I told her that this situation was causing me a lot of stress and anxiety, she laughed again.

I asked her to speak to the doctor and obtain the opening pressure reading. She laughed and told me it was not her responsibility and that it was my responsibility to get the information.

I also spoke to Cindy, who told me that they would not assist me further because Melomed's bills had already been paid.

The manager, Nicole, was supposed to call me, but she has never contacted me to discuss the matter.

The medical aid is not in the wrong. They cannot reassess the claims without the Dr's notes