CW
Christine W

1 reviews | Active since Feb 2015

18 Oct 2015, 21:48

Compassionate Care - Lack of Insight

My mom has an approved Compassionate Care Benefit. We have employed a nursing agency to care for her. Discovery exhausted all the funds we need in her ATB by not paying from this benefit. After hours on the phone and constant back and forth between call centre agents, Nthato Ramushue mailed me on 13/10/2015 saying: \.... the provider must amend the invoices .... The ICD10 code that must be quoted on header and line level of the invoice must only be Z51.5. Then it must....be reprocessed .". The same code has been on the invoices the entire time and I find it unprofessional to be so tight-lipped about their procedures. My family is going through a very trying time and a simple call to explain this would suffice. To go back and forth again to remove the other codes which were provided on her authorisation letter initially (????) feels like a tactic to delay paying what should be rightfully paid. This is not the first incident since my Moms diagnosis and Discovery's lack of insight into what families of patients are going through is disappointing. I have yet to receive further feedback or an actual call from a competent agent. VERY DISSAPOINTED AND FRUSTRATED!"""

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Replies (1)
Discovery Health
Discovery Health's reply23 Oct 2015, 13:48
Official
Hello CWemmer,

Thank you for your post.

We apologise for the inconvenience caused during this difficult time for you and your family.

Our team is aware of your concerns raised regarding claims, which is currently being attended to by our service team.

We were unable to process the claim due to the incorrect codes stipulated on the claim. We have since received the amended claim which has been escalated for review.

We will follow up to ensure that your query is resolved.

Regards
Keymira