1 reviews | Active since Jul 2009
ABSOLUTELY SHOCKING EXPERIENCE WITH DISCOVERY CHRONIC MEDICINE RULE EXCEPTION PAYMENTS
ABSOLUTELY SHOCKING EXPERIENCE WITH DISCOVERY CHRONIC MEDICINE RULE EXCEPTION PAYMENTS
Last year Discovery Health terminated a number of chronic medicines that were previously on the list for chronic medicines as a PMB. These medicines were replaced by sometimes cheaper alternatives and in the case of the statiin concerned it insists on only supplying a medication that is clinically proven to be toxic to me.
Since March 2024 I have been trying to sort out Discovery's complete mess. Once which clearly was done only for one reason: to enrich shareholders further. Finally the substitute medication was approved as an exception after an appeal by my (approved) GP. Rather it was re-approved because I was already on that medication for 5 years anyhow until they took it off the list.
Now the medical aid is incapable of implementing this rule exception. Pharmacy tells me there are other patients who are suffering the incompetence of this medical aid. Or is life deliberately being made difficult for rule exception payments.
With respect this matter is taking to long. I have been trying since March to get matters resolved regarding a rule exception situation for chronic meds.
Will you please sort this out. The claim for a refund of the members "levy" payment was sent on 24 July to your ruleexcptionpayments as per your instructions. And now it has been 8 days or longer. Zero action.
In addition Discovery has paid Clicks pharmacy twice for exception payments where the automatic levy was already paid by myself and has not cooperated in sorting this matter out, not even providing Clicks a payment reference number so they cannot track its erroneous payment. In any event, they have NO WAY of refunding to me.
This is totally your mess, Discovery, because when I sent the two invoices to rule exception payments I included the proof of payment. There was no valid reason for doing this, other than the incompetence of your staff in reading the emails and the attachments.
You nonetheless ignored that and paid the supplier a second time. Why does Discovery make the Member responsible for sorting out its own administrative mess?.
I am now taking this matter to the Ombud and the media, because it is clear that this is a transparent attempt to make it difficult for me to claim for medicines that you have already approved. With respect this matter is taking to long.
Regards
Regards
Regards
Regards
I received ONE phonecall from a junior operator asking me if "I had been paid yet". I said yes, I had been paid for the June claim (submitted THREE TIMES). The rest of the matters were clearly way above her paygrade for her to explore further with me.
Clearly you have a lack of serious business knowledge - or credibility.
I have sent TWO emails to your Principal Officer in with your complaints policy. None were responded to by said Principal Officer although a weak and ineffectual response response was received from a low level employee of Discovery.
You need to answer for a lot, Discovery Health and for me, this has gone way beyond the refunds that you legally owe me.
I am now taking this matter to the Council for Medical Aid Schemes on a matter of principle.
And I will also be adding pain and suffering to my claim, again, based on principle.
I received ONE phonecall from a junior operator asking me if "I had been paid yet". I said yes, I had been paid for the June claim (submitted THREE TIMES). The rest of the matters were clearly way above her paygrade for her to explore further with me.
Clearly you have a lack of serious business knowledge - or credibility.
I have sent TWO emails to your Principal Officer in with your complaints policy. None were responded to by said Principal Officer although a weak and ineffectual response response was received from a low level employee of Discovery.
You need to answer for a lot, Discovery Health and for me, this has gone way beyond the refunds that you legally owe me.
I am now taking this matter to the Council for Medical Aid Schemes on a matter of principle.
And I will also be adding pain and suffering to my claim, again, based on principle.
Regards
Regards
AT 08.30 ON MONDAY MORNING, 19TH AUGUST I WAS INDEED CALLED BY SOMEBODY NAMED FELICIA (I THINK) She APPARENTLY IS a customer relations person from your Chronics Department. She called again same day at close of business to say she was still working on the case.
This is no small task since the number of communication s between your useless organisatIon and myself is standing at closed to 20 times individual communiques ALL - back and forth - CLEARLY WITH ABSOLUTE DRIVEL BEING PROMISED.
heart
HOWEVER there is more.
Here we are, on day 4 following your phonecall to me and ZERO has happened,.
THERE has in fact been a further fact a step BACKWARDS in that a refund claim submitted in July 2024 as per your instructions, including a TILL RECEIPT to prove that I had in fact already paid the so-called non-formulary levv of R300 had been paid by myself as Member on check out back to Clicks AGAIN directly in contravention of the PROOF OF PAYMENT that I had submitted.
SO now the Clicks Head Office has received FOUR payments mad on Rule Exception and the identical amounts have already. You told me a while back that you were unable to EFT payment reference numbers for these four double payments made and that "I should approach the individual pharmacy and request a refund from them" Well pharmacy advises that their payments all go to a head office account.
I need to ask just what the HECK is going on with Discovery Health. I am raising the SAME issue time and time again using YOUR approved channels and more recently HELLO PETER. .
So NO, We are NOWHERE closer to resolution of this disgusting unhappy affair EXcept my abiding regret that I ever chose Discovery in the fist place, 22 years ago.
You inefficiency is now legend in my view and clearly their is nobody in your organisation who actually reads emails.
I must ask, just what it require to be an employee at Discovery these days. Clearly the ability to read, understand and take action and then communicative back is not one of them.
i ALSO NOTE WITH huge concern THAT ALMOST EVERYTHING on your telecentre, lands with a BOT. How in the name of the Almighty can one actually contact living people WHO AN MAKE DECISION S in your hopeless, inept organisation
I AM ALSO ACTUALLY ALSO ACCUSING YOU, DISCheartOVERY HEALTH, OF AGEISM OF THE WORST kind.
I have now resolved to go off statin drugs completely and have instructed my Attorney in my Will to file a lawsuit against your company should I bear the consequences of this by developing heart disease and dying.
So this problem is getting worse, and rest assured your shareholders will hear of this.
AT 08.30 ON MONDAY MORNING, 19TH AUGUST I WAS INDEED CALLED BY SOMEBODY NAMED FELICIA (I THINK) She APPARENTLY IS a customer relations person from your Chronics Department. She called again same day at close of business to say she was still working on the case.
This is no small task since the number of communication s between your useless organisatIon and myself is standing at closed to 20 times individual communiques ALL - back and forth - CLEARLY WITH ABSOLUTE DRIVEL BEING PROMISED.
heart
HOWEVER there is more.
Here we are, on day 4 following your phonecall to me and ZERO has happened,.
THERE has in fact been a further fact a step BACKWARDS in that a refund claim submitted in July 2024 as per your instructions, including a TILL RECEIPT to prove that I had in fact already paid the so-called non-formulary levv of R300 had been paid by myself as Member on check out back to Clicks AGAIN directly in contravention of the PROOF OF PAYMENT that I had submitted.
SO now the Clicks Head Office has received FOUR payments mad on Rule Exception and the identical amounts have already. You told me a while back that you were unable to EFT payment reference numbers for these four double payments made and that "I should approach the individual pharmacy and request a refund from them" Well pharmacy advises that their payments all go to a head office account.
I need to ask just what the HECK is going on with Discovery Health. I am raising the SAME issue time and time again using YOUR approved channels and more recently HELLO PETER. .
So NO, We are NOWHERE closer to resolution of this disgusting unhappy affair EXcept my abiding regret that I ever chose Discovery in the fist place, 22 years ago.
You inefficiency is now legend in my view and clearly their is nobody in your organisation who actually reads emails.
I must ask, just what it require to be an employee at Discovery these days. Clearly the ability to read, understand and take action and then communicative back is not one of them.
i ALSO NOTE WITH huge concern THAT ALMOST EVERYTHING on your telecentre, lands with a BOT. How in the name of the Almighty can one actually contact living people WHO AN MAKE DECISION S in your hopeless, inept organisation
I AM ALSO ACTUALLY ALSO ACCUSING YOU, DISCheartOVERY HEALTH, OF AGEISM OF THE WORST kind.
I have now resolved to go off statin drugs completely and have instructed my Attorney in my Will to file a lawsuit against your company should I bear the consequences of this by developing heart disease and dying.
So this problem is getting worse, and rest assured your shareholders will hear of this.
Regards
Regards