CP
Chantelle P
1 reviews | Active since Dec 2013
18 Aug 2015, 17:38
Claims rejected
I recently submitted claims to which we paid as our MSA are depleted. From what your call centre told me and your maternity benefit forms, we are entitled to 2 scans and 8 visits from the insured benefit. When I submitted the claims I received a notification saying: \Dear Member
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Discovery Health's replyOfficial
20 Aug 2015, 22:51Hello Chantelledp,
Thank you for your patience while I investigated your claims query.
I am sorry for any frustration caused during this experience.
I confirm that we received your second submission of your claims and these were processed the following day. We correctly funded these accounts from your Maternity Insured Network Benefit according to the benefit structure and requirements. We sent you a claims notice outlining how we processed your claims and the reasoning behind funding.
A pro forma invoice is an estimated invoice provided by a seller to a buyer in advance for goods/services. They differ from a normal invoice in not being a demand or request for payment. This type of invoice does not confirm that services were rendered and therefore is not accepted by the Scheme for claims purposes as the Scheme does not pay for services upfront.
I sent you a detailed email with feedback on your claims processing and the options available to you.
Kind regards
Bruce
Thank you for your patience while I investigated your claims query.
I am sorry for any frustration caused during this experience.
I confirm that we received your second submission of your claims and these were processed the following day. We correctly funded these accounts from your Maternity Insured Network Benefit according to the benefit structure and requirements. We sent you a claims notice outlining how we processed your claims and the reasoning behind funding.
A pro forma invoice is an estimated invoice provided by a seller to a buyer in advance for goods/services. They differ from a normal invoice in not being a demand or request for payment. This type of invoice does not confirm that services were rendered and therefore is not accepted by the Scheme for claims purposes as the Scheme does not pay for services upfront.
I sent you a detailed email with feedback on your claims processing and the options available to you.
Kind regards
Bruce
Discovery Health's reply20 Aug 2015, 22:51
Official
Hello Chantelledp,
Thank you for your patience while I investigated your claims query.
I am sorry for any frustration caused during this experience.
I confirm that we received your second submission of your claims and these were processed the following day. We correctly funded these accounts from your Maternity Insured Network Benefit according to the benefit structure and requirements. We sent you a claims notice outlining how we processed your claims and the reasoning behind funding.
A pro forma invoice is an estimated invoice provided by a seller to a buyer in advance for goods/services. They differ from a normal invoice in not being a demand or request for payment. This type of invoice does not confirm that services were rendered and therefore is not accepted by the Scheme for claims purposes as the Scheme does not pay for services upfront.
I sent you a detailed email with feedback on your claims processing and the options available to you.
Kind regards
Bruce
Thank you for your patience while I investigated your claims query.
I am sorry for any frustration caused during this experience.
I confirm that we received your second submission of your claims and these were processed the following day. We correctly funded these accounts from your Maternity Insured Network Benefit according to the benefit structure and requirements. We sent you a claims notice outlining how we processed your claims and the reasoning behind funding.
A pro forma invoice is an estimated invoice provided by a seller to a buyer in advance for goods/services. They differ from a normal invoice in not being a demand or request for payment. This type of invoice does not confirm that services were rendered and therefore is not accepted by the Scheme for claims purposes as the Scheme does not pay for services upfront.
I sent you a detailed email with feedback on your claims processing and the options available to you.
Kind regards
Bruce