Discovery Health
Discovery Healths Hospital Authorisations Pitfalls

29/08 my doctor admitted me to hospital, directly after consultation. Doctor's assistant called Discovery
for authorisation. Due to the severity of my condition I was not able to do it myself. 03/09 I was told by
a hospital staff member that my Plan Type was different from that indicated on my membership card, but
that Discovery had provided the authorisation. I received no further notification from Discovery while in hospital.
The Hospital account was short paid by R5000 . I was told this was a co-payment as I had been admitted to a
non network hospital. The hospital advised that Discovery never informed them that a penalty would apply.
This was also confirmed when the call to discovery was reviewed. I appealed to Discovery to have the
co payment waived because I was not informed of the Penalty 06/09. Discovery advised that the co payment was valid as the authorisation dept. sent a follow up email to confirm the penalty. Neither I or the hospital received this email. If I had been informed of penalty I could have been transferred to a hospital with better facilities closer to home. Discovery Health saved themselves R5000 by not properly informing me of their own
auth. Disclaime

Company: Discovery Health
Country: South Africa
City: Cape Town

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