GET AUTHORIZATION OR DON'T GET PAID - AS I AM UNEMPLOYED. SO NOW MULBARTON HOSPITAL - CHARGE ACCORDING TO THE 80% THE MEDICAL AID WILL PAY! BECAUSE AS I SAID - I AM UNEMPLOYED AND SO IS MY SON!!!!!!!

<p>Absolutely no feedback from the Mulbarton Hospital since all these emails have been sent. Nothing to say the Discovery have contacted them. Only an emails to say DISCOVERY ONLY WILLING TO PAY 80% OF THE BILL.</p> <p> </p> <p>Well as I told them on the 31st, in a terrible state, Get Authorization or transfer my son to the correct hospital, or <span style="text-decoration: underline;"><strong>DON'T GET PAID - AS I AM UNEMPLOYED.</strong></span><strong> </strong><strong><span style="text-decoration: underline;">SO NOW MULBARTON HOSPITAL - CHARGE ACCORDING TO THE 80% THE MEDICAL AID WILL PAY! BECAUSE AS I SAID - I AM UNEMPLOYED AND SO IS MY SON!!!!!!!</span></strong></p> <p><span style="text-decoration: underline;"><strong>From: Sue Du Plessis</strong></span></p> <p><span style="text-decoration: underline;"><strong>Sent: Saturday, 01 April 2017 7:02 PM</strong></span></p> <p><span style="text-decoration: underline;"><strong>To: ********** <p><span style="text-decoration: underline;"><strong>Cc: Douwlene Blom; Amanda Vosloo; Annette Malan; Deleen Liebenberg</strong></span></p> <p><span style="text-decoration: underline;"><strong>Subject: FW: regading Mr Van Der walt ( Keycare)</strong></span></p> <p><span style="text-decoration: underline;"><strong> </strong></span></p> <p><span style="text-decoration: underline;"><strong>To whom it may concern ,</strong></span></p> <p><span style="text-decoration: underline;"><strong> </strong></span></p> <p><span style="text-decoration: underline;"><strong>Request for Authorization</strong></span></p> <p><span style="text-decoration: underline;"><strong> </strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient : Neil Van Der Walt</strong></span></p> <p><span style="text-decoration: underline;"><strong>Date of birth : 16.02.1983</strong></span></p> <p><span style="text-decoration: underline;"><strong>Discovery Keycare</strong></span></p> <p><span style="text-decoration: underline;"><strong>Member number : ********** 72</strong></span></p> <p><span style="text-decoration: underline;"><strong>Dep code : 02</strong></span></p> <p><span style="text-decoration: underline;"><strong> </strong></span></p> <p><span style="text-decoration: underline;"><strong>On The 31.03.2017</strong></span></p> <p><span style="text-decoration: underline;"><strong>At : 18:43</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient was brought in by his family ,</strong></span></p> <p><span style="text-decoration: underline;"><strong>As an overdose , on Tablets</strong></span></p> <p><span style="text-decoration: underline;"><strong>ICD 10 code : t40.6 and x64.9</strong></span></p> <p><span style="text-decoration: underline;"><strong>Overdose on tablets</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient wasn’t stable to move him to his DSP Hospital as per the Dr Kabale , was treated in resus ,</strong></span></p> <p><span style="text-decoration: underline;"><strong>After resus Patient was taken to ICU ,</strong></span></p> <p> </p> <p>On the 01.04.2017</p> <p> </p> <p>Phone the medical aid and I was advise to send an email , so that they can release the auth , as there system wont release an auth as it automatically stats that we are not the DSP</p> <p> </p> <p><span style="text-decoration: underline;"><strong>from: Beverley van der Walt ********** <p><span style="text-decoration: underline;"><strong>to: ********** <p><span style="text-decoration: underline;"><strong>date: 11 April 2017 at 18:55</strong></span></p> <p><span style="text-decoration: underline;"><strong>subject: Fwd: FW: regading Mr Van Der walt ( Keycare)</strong></span></p> <p> </p> <p>Hi Deleen,</p> <p> </p> <p><span style="text-decoration: underline;"><strong>On The 31.03.2017</strong></span></p> <p><span style="text-decoration: underline;"><strong>At : 18:43</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient was brought in by his family , as an overdose , on Tablets</strong></span></p> <p><span style="text-decoration: underline;"><strong>ICD 10 code : t40.6 and x64.9</strong></span></p> <p><span style="text-decoration: underline;"><strong>Overdose on tablets</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient wasn’t stable to move him to his DSP Hospital as per the Dr Kabale , was treated in resus ,</strong></span></p> <p><span style="text-decoration: underline;"><strong>After resus Patient was taken to ICU</strong></span></p> <p> </p> <p>I have posted this complaint on Hello Peter.</p> <p> </p> <p>Please see to it that everyone involved gets a copy of this because I don't have the email addresses.</p> <p> </p> <p>Also see that Sue and Glenda get a copy of this! Glenda and Sue said they got Authorization from Discovery on this and not on the 1st April, but on the 31st when my son was in the Emergency Room. Glenda even gave me her Cell No: in case there were problems - ********** . I was told it was a Life and Death situation and that they had got authorisation for this - because I told them to transfer him if it was not.</p> <p> </p> <p>I also told everyone to get this right, because I am unemployed and if the Bill is not paid - I cannot afford to pay anything and cannot be held responsible.</p> <p> </p> <p>Now, I have written to the Medical Aid and Hello Peter regarding this.</p> <p> </p> <p>I got feedback from the Medical Aid to say that the Mulbarton Hospital has not put Emergency Codes on all the bills.</p> <p> </p> <p>Herewith the email I got from Discovery:</p> <p> </p> <p><strong>from: ********** <p><strong>to: ********** <p><strong>date: 11 April 2017 at 14:55</strong></p> <p><strong>subject: -WRefNo# ********** 473#- -MailRef# ********** 440</strong>#-</p> <p> </p> <p>Dear Mrs Van Der Walt</p> <p> </p> <p>Thank you for contacting us.</p> <p>Membership: ********** 72</p> <p>Claim query</p> <p> </p> <p>As discussed telephonically on 11 April 2017, we are prepared to review the funding of the claim for Mulbarton Hospital, dated: 01 April 2017, as an emergency.</p> <p>Kindly note that the claim has funded as a non-network admission as the patient was stable as per the updates sent to our case managers. If you require us to review the admission as an emergency, we will require comprehensive clinical information from the provider that treated Neil Van Der Walt.</p> <p> </p> <p>The clinical information can be emailed to ********** Please allow 3-5 working days turnaround time.</p> <p> </p> <p>Please note that this is not a guarantee of payment.</p> <p> </p> <p>If you have any more questions, please call us on ***, email ********** or visit www.discovery.co.za</p> <p> </p> <p>Regards</p> <p> </p> <p>Devashnee Abid</p> <p> </p> <p>Kindly see to it that this is corrected. As I said on the 31st March and I will say it again ... I am unemployed ... and if Mulbarton does not do this right ... they will not get paid! My other son was with me as a witness ... in fact he filled in the forms ... and I re-iterated ... if it was not authorized ... you would not get payment from me.</p> <p> </p> <p>Kindly see to it that this is sorted out immediately and please send the Medical Aid what they require ... EMERGENCY CLINICAL INFORMATION ... and the correct EMERGENCY CODES, and please copy me on any correspondence sent to the Medical Aid in order for me to be kept abreast of what is happening.</p> <p> </p> <p> </p> <p>Looking forward to receiving a reply by Return Mail.</p> <p> </p> <p>Beverley van der Walt</p> <p> </p> <p><span style="text-decoration: underline;"><strong>from: Beverley van der Walt ********** <p><span style="text-decoration: underline;"><strong>to: ********** <p><span style="text-decoration: underline;"><strong>date: 18 April 2017 at 11:42</strong></span></p> <p> </p> <p>Good day Deleen,</p> <p> </p> <p>I have not received a reply to my email of the 11th instant.</p> <p> </p> <p>Should this not be forthcoming I will have to put this on Hello Peter as well.</p> <p> </p> <p>I need a reply by return mail.</p> <p> </p> <p>Beverley van der Walt</p> <p> </p> <p><span style="text-decoration: underline;"><strong>18 Apr 2017 11:52 a.m., "Deleen Liebenberg" ********** wrote:</strong></span></p> <p> </p> <p>Good day</p> <p> </p> <p><span style="text-decoration: underline;"><strong>This case has been forward to management. Awaiting their reply.</strong></span></p> <p>Kind regards</p> <p><strong>Deleen Liebenberg</strong></p> <p><strong>Credit Controller</strong></p> <p><strong>Netcare Limited</strong></p> <p><strong>Netcare Mulbarton Hospital</strong></p> <p> </p> <p> </p> <p><span style="text-decoration: underline;"><strong>from: Beverley van der Walt ********** <p><span style="text-decoration: underline;"><strong>to: Deleen Liebenberg ********** <p><span style="text-decoration: underline;"><strong>date: 20 April 2017 at 11:54</strong></span></p> <p><span style="text-decoration: underline;"><strong>subject: Re: FW: regading Mr Van Der walt ( Keycare)</strong></span></p> <p> </p> <p>Good Day,</p> <p> </p> <p>I need as reply as soon as possible.</p> <p> </p> <p>As per your mail of the 1st instant set out below:</p> <p> </p> <p><span style="text-decoration: underline;"><strong>Request for Authorization</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient : Neil Van Der Walt</strong></span></p> <p><span style="text-decoration: underline;"><strong>Date of birth : 16.02.1983</strong></span></p> <p><span style="text-decoration: underline;"><strong>Discovery Keycare</strong></span></p> <p><span style="text-decoration: underline;"><strong>Member number : ********** 72</strong></span></p> <p><span style="text-decoration: underline;"><strong>Dep code : 02</strong></span></p> <p> </p> <p> </p> <p><span style="text-decoration: underline;"><strong>On The 31.03.2017</strong></span></p> <p><span style="text-decoration: underline;"><strong>At : 18:43</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient was brought in by his family ,</strong></span></p> <p><span style="text-decoration: underline;"><strong>As an overdose , on Tablets</strong></span></p> <p><span style="text-decoration: underline;"><strong>ICD 10 code : t40.6 and x64.9</strong></span></p> <p><span style="text-decoration: underline;"><strong>Overdose on tablets</strong></span></p> <p><span style="text-decoration: underline;"><strong>Patient wasn’t stable to move him to his DSP Hospital as per the Dr Kabale , was treated in resus ,</strong></span></p> <p><span style="text-decoration: underline;"><strong>After resus Patient was taken to ICU </strong></span></p> <p> </p> <p>One would think there would be no problems, unless of course, the I.C.D. 10 Codes were incorrect.</p> <p> </p> <p>Hopefully the Doctor and all are concerned are collecting all the relevant information as requested by the Medical Aid and relaying this information to the Medical Aid.</p> <p> </p> <p>It is now 19 days since my son was discharged and I am battling to get any information from the Mulbarton Hospial.</p> <p> </p> <p>When was this sent to Management and how long does it take for Management to get the Doctors report in order for you to forward it to the Medical Aid.</p> <p> </p> <p>Please advise me on this. As per my previous mails, should this not be done correctly, I am unemployed, I have a witness that I requested all authorizations to be done on the 31st or my son should be transferred, and I will not be held responsible for this account.</p> <p> </p> <p>I am writing to the Medical Aid as well, to ask them to inform me when they receive the relevant information.</p> <p> </p> <p>Kindly advise as soon as this is forthcoming.</p> <p> </p> <p>Regards,</p> <p>Beverley van der Walt</p> <p> </p>