Tell your anethetist NOT to give you a PCA PAIN PUMP!

Good morning

I had surgery on 26 June at the Milnerton Mediclinic. The anesthetist made the decision to provide me with a PCA pain pump. At first you classified this item as a non-chargeable item. Then you were provided with a letter from the anesthetist motivating the use of the PCA pain. Now you are telling me that you have a POLICY of only contributing a certain amount towards this item.

From my previous hospital admissions in March 2024 (Milnerton Mediclinic) and September 2022 (Netcare N1 City) when I was also provided with a PCA pain pump, I know that such policy does not exist as you fully covered the item then. Compare the NAPPI code *** from my hospital account of June 2025 (Milnerton Mediclinic) to the previous hospital accounts and you will see this it is the exact same code / item.

As I need to complain to the CMS about this, I need a detailed letter from you explaining why you refuse to cover this item in full.

Note that I also have it in writing from one of your consultants to in future tell the doctor to rather issue me with other medication. I think this is outrageous. Since when does a patient tell a doctor what medication to give???

There is no rejection code on my detailed claim statement that is in line with your "policy" of not fully covering this item.

This was also not made known to me when I requested authorisation and the authorisation letter does not state any exclusions or limits regarding a PCA pump. It does state other limits and exclusions. Yesterday I phoned your authorisation department and was told you do cover the PCA pump. See reference number ***.