EL
Emelia L

1 reviews | Active since Aug 2014

11 Feb 2015, 16:41

Battling to get a claim to be paid out

On 17/01/2015 I fetched my repeat prescription from Clicks. I had to pay cash as the fund was no longer paying for the specific meds. Before I went to get the script, I called and confirmed that the medication will still be covered under my new plan and I was assured that all is fine and I will still be covered. I called to lodge a complaint on the 20th and spoken to Emmah who said I should send the claim in and she will authorize it for payment. On 29/01/2015 I called again and spoke to Nthombi (case manager) who said the money will be paid out within 48hrs. On 05/02/2015 I called again and spoken to Penelope who told me that the money was paid out, but to Clicks. She will reverse it and get it paid to my account within 48 hrs! Today (11/02) I spoke to Kgabi (another case manager) who could not give me a proper answer and who did not want to give me her manager's e-mail address. The \manager"was in a meeting and could not talk to me. Almost a month later and I will have to collect another month's medication without being refunded the previous amount paid! My Membership nr is 368 247 200"""

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Replies (1)
Discovery Health
Discovery Health's reply13 Feb 2015, 12:11
Official
Hello KemptonPark,

Thank you for your patience while I looked into your query.

I would like to firstly sincerely apologise for the inconvenience experienced. We are addressing this internally to prevent a reoccurrence of this nature. We have since reprocessed the claim and will be paying the claim to you accordingly. I have discussed the details of your refund telephonically.

Please feel free to contact us should you require any further assistance.

Kind regards
Rishana