Claim not paid after pre-approval!!!

Dear Complaints Department

We took our daughter in for her teeth at a Sandton Day Hospital. Beforehand my wife called Discovery Ref #: ********** 670 to get the needed approval. Everything was done and portion would be paid by our Discovery Medical aid Hospital benefit and a portion would come out of our savings!

When it came to the claim, that's when Discovery pulls out its tricks.

Firstly they paid a lump sum to my wife's account to pay for this and it came out of our savings, when it should have come out of our Hospital benefits Then they said no the information on the invoice was incorrect. We sent back to the Dentist to add the correct codes. That is fine as the mistake was on the dentist side.

But then after we sent it back, Discovery will find a new thing that needs to be added or that is incorrect. This is my complaint!!! Why do they not explain exactly what you need to have on the invoice, Codes and Practice numbers and the day Hospitals name??? So everytime we would change what was "wrong", only to be told, no now we need the Day Hospital name??? Why did you not tell us all of this from the start!!!! It has been almost a month since the procedure and still the claim has not been settled??!?!

I will tell you why, because DISCOVERY will always find fault when they have to pay out a claim!!!! This is ********* and ****************!!! Very easy to increase your policy yearly?!?!?! Very easy to take your money monthly!?!?! But when they have to pay out a claim that we received Pre-Approval for, they stall and look for issues!?!?!

Myself and my wife are on your medical aid, we are on Vitality, we are on Discovery Life, we have an RA with Discovery... But let me state, I will cancel all of this and take my business elsewhere. Your service is shocking!!!

But you can build a new R3 billion Discovery headquarters in Sandton?!?!?! but you don't want to pay out a claim?!?!?

Please, can we have this resolved as soon as possible?

My wife may be contacted on ********** as she is the main member.

Your urgent response will be appreciated.