Discovery Health
Pain with Process in Oncology

My wife is under treatment for breast cancer. She has been registered with oncology at Discovery. During her follow-up visit to the oncologist the mammogram indicated calsifications in the same breast where the cancer was removed, requiring a biopsy which the radiologist recommended should be done by stereotactic procedure. The oncologist motivated the biopsy as part of the oncology basket but Discovery turned it dowm since it was not part of the oncology basket. It would have to be paid out of the MSA. Two specialists indicated they cannot understand the mentality of Discovery since it is still part of the cancer treatment. Even the radiologist couldn't understand the reasoning. All we get is a flat -sorry its all about codes and the code submitted is not part of the oncology basket- full stop. Brick wall. If my wife follows the other procedure oncology will pay for it even though it is much more expensive (4x) and it will not come from the MSA. It is slightly more inconvenient but it will be the way we go even though it will cost Discovery more. The back and forth delay could be life threatening and makes it as unpleasant as possible for members.

Company: Discovery Health
Country: South Africa
City: Durban

  <     >