AfricaComplaints.com » Health & Medicine » Complaint / review: Discovery Health - Nearly died and Discovery not paying the bills | #174644

Discovery Health
Nearly died and Discovery not paying the bills

Please see this in reference to the complaint logged with Discovery: 22:47 Tue 30 Jul.

Discovery is being unethical and when you need them they will not come through for you. Free gym will only take you so far. You need to get a real medical aid with honest and ethical caring people at the helm. Discovery is not that. Read Discovery's response on the complaint and then see my rebuttal below:

The final ICD-10 code on this account was for an emergency admission with first suspected and then proven meningitis. IF YOU HAVE MENINGITIS YOU ALSO HAVE A HEADACHE. ARE YOU SERIOUS REJECTING THE CLAIM!

They know that any emergency, no matter what the cause, is by law a PMB. The medical schemes act states that the diagnosis and care of all PMB conditions, including emergency conditions have to be paid in full. This was an emergency and the final discharge ICD-10 code that of meningitis. Even if the final discharge code was not PMB, if you are being treated for a suspected PMB condition, the Medical Schemes Act and PMB Code of Conduct states that you have to honour that. They are breaking the law! Not only is meningitis a PMB, but it is life threatening!

Yet, they still ignore it!!

Date:

Company: Discovery Health

Country: South Africa   City: Medical Advisory Services

Category: Health & Medicine

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