Discovery Health Complaint
 SUPPLIER |
Discovery Health |
 INDUSTRY |
Medical Aid | ||
| BRANCH / AREA | Cape Town | COUNTRY | South Africa | ||
| TIME / DATE | 14:13 Wed 13 Mar | PERSON RESPONSIBLE | Adrian Gore | ||
| CUSTOMER | Berne Muthien | View all reports by user |
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| PROBLEM | Breach of Contract |
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| INCIDENT | Wed 13 Mar | ||||
| HEADLINE | Discovery hospital plan covers surgery but not MRI |
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| I hv Classic Core (hospital) plan w Discovery since 1999, member #052655740. I need excision of lump in neck, set for 20 March 2013. Surgeon cant do surgery without MRI. I was to check into hospital, hv MRI, then surgery, on same day. Discovery staff on 6 March authorise MRI, surgery & biopsy, as in-hospital treatment. Yet on 12 March Discovery staff refused to cover MRI for spurious reasons incl that MRI is diagnostic & optional. Adrian Gore's assistant, "Yoshan" (?), called me after I contacted the media on 12 March to say MRI is not covered cause it is not done in theatre (!). He also said MRI not covered cause it can be done at wil, but surgery date is also set at wil. His arguments make no sense. Discovery website: "Your cover for MRI &CT scans in hospital: We pay up to 100% of Discovery Health Rate from ur Hospital Benefit if yr MRI or CT scan is done as part of an approved hospital admission; We dont pay for your MRI or CT scan if you admitted for conservative back &neck treatment, or if scan is unrelated to your hospital admission." [URL Removed] . Discovery must urgently agree to pay for my MRI in-hospital. | |||||
| SUPPLIER'S RESPONSE | Discovery Health | Time and Date | 16:12:14 | Wed 13 Mar 13 | ||
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Hello Berne Muthien, Thank you for your comment. I confirm that you have been contacted by our CEO's office regarding your query, and you have been provided with comprehensive feedback. You have advised that a complaint has been lodged with the Council of Medical Schemes and please correspond with them for feedback on your case. Kind regards Genevieve |
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Comments
Relevant content (Last 5 Breach of Contract Problems)
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13:34:20 Sat 18 May 13
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