1 reviews | Active since Aug 2016
Claims
<p>So disappointed with Discovery I have had my medical aid for about 7 years more or less only went to hospital twice and my child once, I went in for a operation in April 2016 and the anaesthetist gave me an injection called Bridion. On the day I called for authorization the call center person never told me that there will be exclusions and t & c’s apply. So months later I get a phone call form Ismail & Dahya Attorneys advising me I need to pay R957.70 plus attorney fees, so I phone Discovery not that it was much difference as they advise me they don’t see it as a authorized drug so my reasons is must you tell the anesthetist while doctor is busy operating does Discovery pay for that if not you can give it to me like you can do that in theater. So I contacted the broker so she advised me to get a motivational letter from the anesthetist witch I did and she forwarded so after all of this since September 2016 (they approved the drug in September) they tell me now Discover won’t pay the claim, funny how they paid two other patients claims for the same drug in June that the reception advices me that Discovery paid it she can’t see why the wont pay for my claim. So now I have to pay the R957.70 plus the interest and fees. Thank you Discover while you eat my payments away month after month and can’t pay this must be going badly if I pay you per year R40920.00 and you can’t even pay a claim of R957.70</p> <p> </p>
Dear kwlefevre
We’re sorry to hear you’re dissatisfied. Please give us a chance to look into your query and we’ll be in touch soon.
Regards
Discovery Health Servicing Team
Dear kwlefevre
We’re sorry to hear you’re dissatisfied. Please give us a chance to look into your query and we’ll be in touch soon.
Regards
Discovery Health Servicing Team
Dear kwlefevre
We can confirm that we have sent you final feedback by email.
Regards
Preeti Jagjiwan
Dear kwlefevre
We can confirm that we have sent you final feedback by email.
Regards
Preeti Jagjiwan
Discovery still wont pay the claim
Discovery still wont pay the claim
No we can not confirm this was sorted out as you blocked all my mails going to yo!!!! Here is my proof! Your email message was blocked
16 minutes ago at 10:33 PM
From
To
Cc
Bcc
Reply-To
The following email message was blocked by MailMarshal:
********** ********** />Subject:Re: Pre-authorisation call for 12 April 2016, membership number: ********** 10 -MailRef# ********** 296#-Message: B582ea0cd0000. ********** 00001.0007.mml
Because it contains a sound file.
If you believe the message is business related, please forward this block notification message to ********** and request that the message be released. If no contact is made within 5 days the message will be automatically deleted.
MailMarshal Rule: Discovery (Inbound) : Block Sound Files
No we can not confirm this was sorted out as you blocked all my mails going to yo!!!! Here is my proof! Your email message was blocked
16 minutes ago at 10:33 PM
From
To
Cc
Bcc
Reply-To
The following email message was blocked by MailMarshal:
********** ********** />Subject:Re: Pre-authorisation call for 12 April 2016, membership number: ********** 10 -MailRef# ********** 296#-Message: B582ea0cd0000. ********** 00001.0007.mml
Because it contains a sound file.
If you believe the message is business related, please forward this block notification message to ********** and request that the message be released. If no contact is made within 5 days the message will be automatically deleted.
MailMarshal Rule: Discovery (Inbound) : Block Sound Files
Here is the mail that was blocked
Morning
I realize now you will think of any excuse in the book not to pay for this claim.
Even though yes at the end of the call it states like you said "scheme and billing rules apply that doesn't get explained by anyone properly not even the agent you talk to and I never received your T&C's to explain that and excuse me but I'm no lawyer to know that that's what it meant and that if your on an operating table and you need meds to keep you form dying of paralysation that you need to pay out of your own pocket cause it not an authorized medication according to the medical aid, so how are a person to decide weather you can get certain meds according to you scheme if you have no idea what you will be given in an case of emergency? So I was never sent a list of approved medication to discuss with the doctors and no one inform you of what meds is approved and what meds not and nowhere can you view what is ok and what not.
any excuse not to pay for anything more than what you should and to upset and frustrating people paying for medical aid and not getting it, any excuse not to pay for anything!
Here is the mail that was blocked
Morning
I realize now you will think of any excuse in the book not to pay for this claim.
Even though yes at the end of the call it states like you said "scheme and billing rules apply that doesn't get explained by anyone properly not even the agent you talk to and I never received your T&C's to explain that and excuse me but I'm no lawyer to know that that's what it meant and that if your on an operating table and you need meds to keep you form dying of paralysation that you need to pay out of your own pocket cause it not an authorized medication according to the medical aid, so how are a person to decide weather you can get certain meds according to you scheme if you have no idea what you will be given in an case of emergency? So I was never sent a list of approved medication to discuss with the doctors and no one inform you of what meds is approved and what meds not and nowhere can you view what is ok and what not.
any excuse not to pay for anything more than what you should and to upset and frustrating people paying for medical aid and not getting it, any excuse not to pay for anything!
Dear kwlefevre
We have contacted you with a resolution to your issues.
Regards
Cornelius
Dear kwlefevre
We have contacted you with a resolution to your issues.
Regards
Cornelius