CM
CANDICE M
1 reviews | Active since Apr 2013
01 Feb 2016, 09:49
CLAIM REFUND
I have a query with my claim. There is a procedure that is meant to come from risk benefit but it has been taken from my MSA. Second, there is an admin amount from the specialist that Discovery says: \This procedure code is not in use for this date of service. You are not responsible for payment.\" yet, I have paid for it and not being refunded for it. Can someone explain this line please? I am always struggling with claims with this company. "
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Discovery Health's replyOfficial
02 Feb 2016, 11:06Hello CANDICEMNC,
Thank you for your comment.
We fund for Out of Hospital claims from your Medical Savings Account (MSA), as long as you have money available.
As a healthcare funder, we have a responsibility to our members to provide access to top quality healthcare, while ensuring the long-term sustainability of the scheme. We make decisions regarding the funding of medical procedures and services according to rigorous criteria to ensure that we meet both these objectives.
Following our telephonic conversation, I trust that my explanation provided some clarity as to how your claim was funded. I am glad that you understand why the claim was from your MSA and the reason behind Discovery Health not paying for certain codes.
Regards
Meryl
Thank you for your comment.
We fund for Out of Hospital claims from your Medical Savings Account (MSA), as long as you have money available.
As a healthcare funder, we have a responsibility to our members to provide access to top quality healthcare, while ensuring the long-term sustainability of the scheme. We make decisions regarding the funding of medical procedures and services according to rigorous criteria to ensure that we meet both these objectives.
Following our telephonic conversation, I trust that my explanation provided some clarity as to how your claim was funded. I am glad that you understand why the claim was from your MSA and the reason behind Discovery Health not paying for certain codes.
Regards
Meryl
Discovery Health's reply02 Feb 2016, 11:06
Official
Hello CANDICEMNC,
Thank you for your comment.
We fund for Out of Hospital claims from your Medical Savings Account (MSA), as long as you have money available.
As a healthcare funder, we have a responsibility to our members to provide access to top quality healthcare, while ensuring the long-term sustainability of the scheme. We make decisions regarding the funding of medical procedures and services according to rigorous criteria to ensure that we meet both these objectives.
Following our telephonic conversation, I trust that my explanation provided some clarity as to how your claim was funded. I am glad that you understand why the claim was from your MSA and the reason behind Discovery Health not paying for certain codes.
Regards
Meryl
Thank you for your comment.
We fund for Out of Hospital claims from your Medical Savings Account (MSA), as long as you have money available.
As a healthcare funder, we have a responsibility to our members to provide access to top quality healthcare, while ensuring the long-term sustainability of the scheme. We make decisions regarding the funding of medical procedures and services according to rigorous criteria to ensure that we meet both these objectives.
Following our telephonic conversation, I trust that my explanation provided some clarity as to how your claim was funded. I am glad that you understand why the claim was from your MSA and the reason behind Discovery Health not paying for certain codes.
Regards
Meryl