Discovery Health
Mess up with the coding system

I wrote on this subject 15 days ago, about my cervical implants that that I got authorization for verbally and written and now they only want to pay for one implant and are telling me that I had an unauthorized procedure. The code they are disputing is 22856, this is for a total disc arthroplasty, it is part of the operation I had, it appears the right hand doesn't know what the left hand is doing at discovery!! It also appears they they have non medical personnel dealing with this, I am in the medical field myself. I now have a letter of final demand from the hospital for R20 000!! I had this op on the 13 Set 2013.
Please someone help me, other wise I am going to take this further with the ombudsman and will also be getting legal advice and writing letters to the newspapers. I know my rights. I asked if the op was covered and I know the conversation was recorded, they told me not to worry I was TOTALLY covered.
The visit number was 431429 and my medical aid number 115784400

Company: Discovery Health
Country: South Africa
City: Western cape

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