1 reviews | Active since Nov 2010
2015 claim incorrectly paid from 2016 benefits
On 09.12.2015, I submitted a claim dated 02.09.2015 from my Prosthodontist. (Claim ref ***)<br> The claim was only partially PD as the one line on the invoice was actually an invoice from a 3rd party - Discovery requested a copy of this 3rd party invoice in order to be able to process this portion of the claim. R14,647.79<br> Unfortunately, the Drs rooms were closed for Xmas by this time and I was only able to get the invoice from the 3rd party on the 21.01.2016<br> I submitted this, with the original ref no as this was a 2015 claim. (Claim ref ***)<br> R14,203.79 was paid to me on 10.02.2016<br> I know that there was a limited amount left in my 2015 ATB due to the option I was on in 2015 and that only R1921.54 was paid from ATB.<br> I was not expecting to be refunded the full amount as I knew I was close to my ATB limit - I just didn't know how much was left.<br> The balance of the claim was paid from my 2016 MSA, because according to the consultants I spoke to, the date on which the claim is received is used as the claim date - not the date of service. <br> I would like to pay back the amount refunded to me from 2016 MSA so I have benefits for 2016 but I am told this isn't possible. Pls assist
Thank you for your comment.
We confirmed that the relevant team has been in touch and provided you with feedback regarding your query.
We investigated your query and also confirmed that we will be able to put back your Medical Savings Account (MSA) that was paid to you as part of a claim.
We do understand this is not the feedback you had hoped for however it is in line with the Scheme rules.
Regards
Discovery Health Servicing.
Thank you for your comment.
We confirmed that the relevant team has been in touch and provided you with feedback regarding your query.
We investigated your query and also confirmed that we will be able to put back your Medical Savings Account (MSA) that was paid to you as part of a claim.
We do understand this is not the feedback you had hoped for however it is in line with the Scheme rules.
Regards
Discovery Health Servicing.
