ML
Marne L

1 reviews | Active since Apr 2013

31 Jan 2018, 11:35

Absolute poor service regarding pregnancy claim

I am currently pregnant ( 22 weeks ) On 3 January 2018 I visited my network gynecologist for my monthly check up. On 5 January 2018 my Discovery app updated and I saw this pregnancy mode which I then activated. The doctor's office put in the claim as usual and then on 9 January 2018 I got the email to say that you will not pay my claim as I need authorization to visit a specialist. I phoned and the guy told me the claim was ejected because I visited the doctor on 3 January and only activated my pregnancy app on 5 January ( I was not aware that we had to activated the pregnancy app on 1 January ) he told me to phone the doctor's office and ask them to reverse the claim and then put it in again, which they did. on 15 January 2018 this claim was rejected again for the same reason. I phone again and then I was told that there is some kind of issue with this pregnancy mode thing and that he would escalate my claim and gave me this reference number ********** 026. I must visit the doctor again tomorrow ( 1 Feb 2018 ) and they want their money for my visit on 3 January. So I phoned this morning to follow up on the 3 January claim. The guy who helped me had this bad attitude just telling me there is a system error and nothing he can do and asked me why I was given this reference number, which I feel he should be able to see on his system. Meanwhile he just told me to ask the doctor's office to phone you guys to confirm the system error. I feel this is inappropriate. The doctor's office and I are very inconvenienced by this. This is not their or my problem - it is your problem and still after a month has not been solved!!! Not once did he mention sorry for the inconvenience or anything. Just kept saying system error system error. I went to check on my app and still the cover and benefits STILL is not working. not once did I receive and email or sms stating the system error you guys are experiencing with this pregnancy mode. I am very upset.

0
Replies (3)
Discovery Health
Discovery Health's reply31 Jan 2018, 14:30
Official

Dear MissMarne

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

Discovery Health
Discovery Health's reply02 Feb 2018, 13:52
Official

Dear MissMarne

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

Regards
Discovery Health Servicing Team

ML
Marne L's update06 Feb 2018, 10:33
Reviewer Update
Rosanne Govender phoned me on Thursday and apologized for the way I was spoken to and promise to handle the situation for me as soon as possible, this morning I received my email from the claim department stating that my claim will be paid on 12 February 2018. Thank you Rosanne for the way you handled everything and for speaking to me in a kind and understanding manner. Discovery Health is lucky to have you.