Sign up with GoogleI ended up helping her and after the surgery, sent this email to the doctor:
Dear Dr.,
This letter does not concern your medical abilities or any legal aspects of your practice.
You are treating / have treated an acquaintance of mine who is on Discovery Comprehensive.
Firstly an observation: On 11 June, you asked Discovery to authorise the treatment, but they didn't respond for several reasons :
1. According to their website, the official channel to ask for authorization is by telephone, but you emailed them. (Some people may have success by email, but they are either lucky or they know Discovery's processes intimately). Be prepared to follow up any email with a telephone call.
2. Discovery wants to know when the treatment will be done. Supplying a tentative date and time is allowed, but then they want a commitment that the final date will be shared with them.
3. The email was directed at the patient and only CCed to Discovery. They may interpret "Please authorise" as a request to the patient.
4. The email contained a lot of Afrikaans. Maybe the recipient can't understand Afrikaans and doesn't want to risk a misunderstanding.
Now for my advice: You are contracted in on this plan which means your payment is guaranteed with minimal hassle. So you should really give patients like this the VIP treatment and make a decent effort to communicate with the medical aid. The time required is minimal compared to dealing with clients who do not pay in full. Even moreso because she struggles to communicate with Discovery herself. (She has a hearing problem, she cannot email and she has no blood relatives in Pretoria.)
One more grievance: You have a form where the client acknowledges that all treatment options were explained in a reasonable manner to her. Given that the document is mandatory, I am really disappointed that you made so little effort to remind her to sign it.
I just want to make sure you understand why Discovery asks so many questions: They have accountants and systems to detect irregularities. Be it mistakes or outright fraud. Irregularities may not matter to you and it may not matter in the short term. But they push up medical aid contributions, which is already the largest single expense for some people I know.
And Discovery may well have a policy that staff not answer anything by email. Any large organization is really scared that a junior employee may make unrealistic commitments.
I'm not an employee, shareholder or member of Discovery.
Yours sincerely,
Nic
Dear Dr.,
This letter does not concern your medical abilities or any legal aspects of your practice.
You are treating / have treated an acquaintance of mine who is on Discovery Comprehensive.
Firstly an observation: On 11 June, you asked Discovery to authorise the treatment, but they didn't respond for several reasons :
1. According to their website, the official channel to ask for authorization is by telephone, but you emailed them. (Some people may have success by email, but they are either lucky or they know Discovery's processes intimately). Be prepared to follow up any email with a telephone call.
2. Discovery wants to know when the treatment will be done. Supplying a tentative date and time is allowed, but then they want a commitment that the final date will be shared with them.
3. The email was directed at the patient and only CCed to Discovery. They may interpret "Please authorise" as a request to the patient.
4. The email contained a lot of Afrikaans. Maybe the recipient can't understand Afrikaans and doesn't want to risk a misunderstanding.
Now for my advice: You are contracted in on this plan which means your payment is guaranteed with minimal hassle. So you should really give patients like this the VIP treatment and make a decent effort to communicate with the medical aid. The time required is minimal compared to dealing with clients who do not pay in full. Even moreso because she struggles to communicate with Discovery herself. (She has a hearing problem, she cannot email and she has no blood relatives in Pretoria.)
One more grievance: You have a form where the client acknowledges that all treatment options were explained in a reasonable manner to her. Given that the document is mandatory, I am really disappointed that you made so little effort to remind her to sign it.
I just want to make sure you understand why Discovery asks so many questions: They have accountants and systems to detect irregularities. Be it mistakes or outright fraud. Irregularities may not matter to you and it may not matter in the short term. But they push up medical aid contributions, which is already the largest single expense for some people I know.
And Discovery may well have a policy that staff not answer anything by email. Any large organization is really scared that a junior employee may make unrealistic commitments.
I'm not an employee, shareholder or member of Discovery.
Yours sincerely,
Nic
