Discovery Health
Unwilling to cover specialist visit and procedures

My wife received a referral from our gp to see a specialist. This authorisation and appointment process takes months. I know this as we have been through it. This was an urgent matter and thus we saw an out of network specialist. I called for authorisation and they needed to talk to the GP which was not possible. I decided to rather pay cash.

The specialist referred to a cat scan and xrays, also urgent and the appointment was made for the next day. I again called the medical aid and was advised that we require a referral from the specialist. We got this and again called and spoke to Rowan who was exceptionally unknowledged on the topic. He put me on hold for 5 min to read up on the matter. After his learning session he said that I now need a referral from the GP to load a specialist author. The same author I gave up on previously.

I believe these procedures are designed to withhold payment. In the mean time people's lives are at stake and waiting is not always an option. Now Im running around all over the place trying to get authorisation. Why can this not happen afterwards. Doctors do not wait around to call for emergency auth.

Company: Discovery Health
Country: South Africa
City: Specialist auth

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