BM
Buke M

1 reviews | Active since Jan 2010

12 Oct 2017, 09:53

Claims for pre-approved treatment rejected

Can someone please help as I am getting tired of following up on the issue weekly, get promised feedback and action but only to get the claims rejected every week.

This email address given, ********** ,to me to use for sending claims for the approved treatment only sends automated email messages. I have sent several emails to this address and not once have I received any valid response.

Last week I spoke to another consultant and Ntombi several times. Ntombi assured me that the outstanding claims for OT and Speech Therapy will be re-processed, approved and be on the payment run scheduled for the past Sunday and should receive the money in my account by Wednesday the 11th of October. Waited for Wednesday and only to receive an email that the claims have been rejected.

I truly believe Discovery and the scheme BankMed is taking me for a ride. How can a claim I submitted at the beginning of September for August sessions still be outstanding in the middle of October? I even sent two more claims and all of them get rejected. The benefits for both OT and Speech have been approved for my daughter but all three invoices submitted for claim subsequent to the benefits being approved get declined! What must I do when this is clearly the worst service ever? Call the contact centre once again to relay the same story and listen to different people ‘apologising’, make promises and then still not re-imburse me for the claims?

I need Discovery/BankMed to reimburse me for those claims today and I do not want to hear any more empty promises. The treatment has been approved and I find it very difficult to understand why claims for the pre-approved treatment always get rejected even when I call in weekly and send follow up emails.

0
Replies (3)
Bankmed
Bankmed's reply12 Oct 2017, 12:05
Official

Dear Hlubi04

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.

Regards
Discovery Health Servicing Team

Bankmed
Bankmed's reply16 Oct 2017, 09:14
Official

Dear Hlubi04

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team

BM
Buke M's update18 Oct 2017, 11:19
Reviewer Update
My long-outstanding claims were finally supposed to be paid at the latest last week Wednesday. When I spoke to Ntombi last week, she said there was a system glitch and the payment would be effected. It’s a week later and the claims still not reimbursed, am I meant to still believe that BankMed/Discovery is still sorting out the system glitch for the entire week? Tinyiko also contacted me and promised to follow up with me. It's Wednesday, my query still not addressed and have not heard anything from both Ntombi and Tinyiko!