JE
Janie E

1 reviews | Active since Apr 2018

10 Jan 2022, 13:01

Day-to-day Extender Benefit Coverage Omitted

Good day,

I have submitted this query with Discovery claims department early December already and I only received feedback earlier today.

It is evident from the reply received that even after a month my email was not properly read.

On 9 September 2021 we took our 1 year old daughter to the casualty at Linmed Benoni. As per the benefits breakdown for our plan (Classic Saver), even though our MSA was depleted, we have the day-to-day extender benefit that allows coverage for 2 casualty visits for kids under 10 years old.

Before we left for the hospital I did phone Discovery and confirmed with a consultant beforehand the details of the benefits and the steps that had to be taken for us to receive the coverage. We worked on the advise of this consultant.

I will appreciate if this matter will be sorted out because now none of these accounts have been paid and the response I have received from Discovery is unacceptable.

0
Replies (5)
Discovery Health
Discovery Health's reply11 Jan 2022, 07:43
Official
Dear Janie E 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 
JE
Janie E's update12 Jan 2022, 09:28
Reviewer Update
Hi,

I have not received any feedback as of yet.
Discovery Health
Discovery Health's reply12 Jan 2022, 10:15
Official
Dear Janie E We have been in touch with you to answer your comments. Regards Discovery Health Servicing Team 
JE
Janie E's update15 Jan 2022, 08:55
Reviewer Update
This amount has been deducted from my 2022 MSA when it incurred and should have been deducted from the day to day benefits for 2021 as per your phone call.

How convenient to wait until the new year to attend to queries so that you can avoid paying anything.

I am sure if the doctors waited this long to process a claim it would be considered *****!!
JE
Janie E's update17 Jan 2022, 13:57
Reviewer Update
This is truly unbelievable and I am shocked at the way Discovery will avoid everything to pay anything from the scheme! Not paying something, not answering queries in time, just so that you can pay it ultimately from our new MSA is *****! I want this sorted out or I will be contacting the medical aid ombudsman! If a service provider changed the date of service in the name of getting a claim through it would be **********!

This should have been paid from the day-to-day extender benefit of 2021 and NOT the MSA for 2022.