1 reviews | Active since Jan 2010
Battle to get my GP's bill paid in full - just because I visit a Homeopath who is also a registered GP
I find it bazaar that in South Africa we pay a huge monthly cost towards medical aid, which obviously has its benefits. However I constantly experience problems with some claims from my GP who is also a Homeopath. The call centre agent advised me that there was no nappi code and some other reasons also noted, which is a general reason for non-payment. My claim is now outstanding for 2 months, but yet Discovery has made no effort in contacting the Homeopath or giving me prompt feedback. I had to call back in order to confirm the status of my query and got very irate in the process. The disturbing fact is that claims for my GP only get paid after I kick up a racket because Discovery first only pay a couple of rands****erally) towards the claim. I then call Discovery, frustrated, to get told to need to fill out a form requesting for claims to be paid in full.
I really cannot understand what the problem is as I have R3730 in my MSA and to top this off, if you check my medical history over the years, they have become less and less because of the medication I use.
My claim has been rejected after applying for an exception citing the aforementioned reasons, however they always get approved eventually, e.g. WRefNo#***#- -MailRef#***#- - 31/10/2018 my claim of R454,56 was paid after the same exception process, not sure why it was paid then and not now.
Needless to say, I am not very happy with this, as I do not abuse my medical aid in any way, and for Discovery to constantly make it a battle to get my doctors bills paid and for me to be out of pocket when I have savings available is completely unacceptable. I also usually get an email to confirm is my query was resolved, but to date I have not. I have only received a call from a call center agent, so where is the consistency Discovery?
Regards
Discovery Health Servicing Team
Discovery Health Servicing Team
Thanks
Thanks
Thanks,
Nicholette
Thanks,
Nicholette
