1 reviews | Active since Dec 2011
Claim error not resolved. No follow-up or ownership in assisting me.
- I have 5 claims associated with an incorrect pre-auth code. As a result, Discovery has only paid 70% to each of the health-care providers. I have been in contact since 13 December 2018 and have not had a satisfactory response or care to help me resolve the issue.
- We obtained, in June, pre-authorisation for a Caesarean-section delivery ( ********** 0) My wife went into labour a week earlier than anticipated on 3 December. We were admitted to Park Lane hospital as per the pre-auth. - (I think) The hospital submitted the claim without the pre-auth and as a result a new auth code was generated ( ********** 6). - I was in contact with discovery by email (13 Dec) initially to which I did not receive a reply in line with the query I made (I was told I need to motivate why I didn't obtain a pre-auth code). - I then contacted Discovery on 18 December by phone to resolve. I was told that it would be resolved and the 30% co-payment (for decision code 70) would be waived and I would have feedback on Thursday 20 December. I received no call and no change to my claims has been made. - I DM'd Discovery on Twitter and was told someone would be in touch with me. Nobody got in touch. I tweeted publicly next, and no reply. - I phoned on Friday 21 December to which it seems the team was not able to find record of my query. I then did manage to have some feedback (but later I realised it was feedback on another issue raised by a healthcare ptovider, and not my query). - It is 24 December and I still do not have feedback.
I'm very frustrated as the claims total over R70,000 and the healthcare providers are asking me for payment for the remaining part. I am deeply disappointed with the lack of response or assistance. Every time I get in touch I have to re-explain the situation and it seems that nobody has the ability to actually help me. I need this resolved as a matter of urgency. I can't afford to wait xx working days every time I phone/Email discovery.
Discovery Health Servicing Team
Discovery Health Servicing Team
We have contacted you with regards to your comments.
Kind regards
Discovery Health Servicing Team
We have contacted you with regards to your comments.
Kind regards
Discovery Health Servicing Team
