nM
nomfundo M

1 reviews | Active since Sept 2016

17 May 2019, 12:36

cliams processing delays.

i am very unhappy with the delays that discovery health has caused in processing my claim! i submitted a claim on the 7th of May 2017. i then received a response 3 days later advising that the invoice was not clear- they could not see the codes . i asked the consultant to call DR SONI and get the codes, then i was told that Discovery cant take the information via the phone. i requested a clearer copy of the invoice from the doctor , and submitted another claim on the 14th of May- of which this time around i was informed that the invoice was not attached therefore claim declined. This was actually not correct as there was an invoice attached. i spoke to another consultant who had a look at the email i sent, and she picked up the attachment. She then told me she needs to re submit the claim again!!!! which means another 3 day wait. So the claim was submitted again on the 15th of May, and today the 17th of May i call again to follow up, and i spoke to Xolani who advised me that the claims department says they cant make out the service date on the claim !! how is this possible because i can definately see it on my side ??? 2 full weeks of delays ?? I payed the doctor cash because it was working out cheaper then him claiming from medical aid, but now i regret doing this as i am going back and forth with claiming my money back from discovery . I dont understand why the claims department does not phone the provider if anything is unclear !

My membership number is ********** 70 Claim reference number: ********** 078, and today we resubmitted the claim with reference number ********** 880.

Please urgently advise

0
Replies (3)
Discovery Health
Discovery Health's reply17 May 2019, 14:30
Official
Dear  nomfundomk 

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 

Best regards,

nM
nomfundo M's update20 May 2019, 14:19
Reviewer Update
i still have not had feedback regarding this!! when i first submitted the invoice i was told the amount is not clear- i resubmitted and now i am told the codes are not clear. Then i submitted again and this time i am told the date of service is not clear !!!! This is soooo annoying . Discovery why do you keep making endless excuses !!

Discovery Health
Discovery Health's reply21 May 2019, 14:41
Official
Dear  nomfundomk 

We have been in touch to answer your comments.

Regards
Discovery Health Servicing Team 

Best regards,