MS
Mongezi S

1 reviews | Active since Jan 2019

27 Nov 2020, 23:58

Claims Process

If it were possible to rate less than one star I definitely would have done that. I submitted a claim with Discovery after paying cash at the Dr's practice. The claim had all the information I thought they would require. Claim gets rejected as there was no procedure code on the statement, understandable. I request the practice to update the statement with the procedure code, which they do and I send the amended statement to discovery. Guess what, claim gets rejected with the reason that the ICD-10 code used does not exist, the same ICD-10 code that was on the initial statement. Why was I not told this when the claim was initially rejected. Now I need to go back to the Dr and request for a further amendment (this on a code thathe Dr assured me that is correct). The consultant, who by the way was the third person I needed to explain my situation from scratch to as their lines had issues today and my calls kept getting hung up, confirmed that the ICD-10 code was correct but that it might be outdated and advised i asked the provider to call in to get the correct Information. Anyways, I've had my fair share of disappointments from Discovery. I will not be doing this back and forth anymore, I have cancelled my membership with them. Congratulations Discovery, you take the cup for the worst customer experience I have had. Well done.

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Replies (2)
Discovery Health
Discovery Health's reply30 Nov 2020, 07:18
Official
Dear Mongezi S

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. 

Regards Discovery Health Servicing Team

Discovery Health
Discovery Health's reply30 Nov 2020, 14:10
Official
Dear Mongezi S We have been in touch with you to answer your comments. Regards
Discovery Health Servicing Team