1 reviews | Active since Jun 2014
Delayed payments
Dear Sir/Madam<br> <br> I have claims outstanding as far back as mid Feb 2015. I followed up in April and I was asked to resubmit the claim. And I did as advised. When I followed up today, 28th May 2015, I was informed that there was missing information on the docs I had sent - info such as nappi codes, dosage and strength. My question is why does it take so long to inform me about the supposed missing information as Discovery Health has my contact details as well as that of the practitioner? So, if I hadn't called they would have been happy to move right along? <br> <br> Another claim which I submitted at the beginning of May is simply not appearing on their system (according to the call centre agent) yet I have a reference number form the very claim generated by their system. I have to resubmit. I did, and I have already received yet another reference number but it no longer gives me comfort as it seems their admin systems are not working. <br> <br> Today, I spent 40 minutes on the phone trying to resolve these issues - my time and money! <br> <br> I am reconsidering my decision of being a discovery health member as it seems to invite more stress than peace of mind I thought I would get. <br> <br> Ndumi H.
Thank you for your comment.
I investigated your query and confirmed that the claims in question have been processed on your membership. We process claims based on information provided on the claim. I confirmed that one claim was incomplete and sent you an email with the details of the claim. Once we receive the amended claim we will process the claim further. Please accept my sincerest apologies for the manner in which your query was handled.
Remember when claims are submitted to the Scheme for re-imbur*****t the claims must include the following information:
o Your membership number
o Patient's name
o Healthcare provider's name
o Healthcare provider's practice number
o Account number
o Treatment date
o Tariff/Procedure/NAPPI codes
o Amount claimed
o Diagnostic code (ICD-10 code per line billed)
Thank you for allowing me to assist with your query.
Kind regards
Jashvir
Thank you for your comment.
I investigated your query and confirmed that the claims in question have been processed on your membership. We process claims based on information provided on the claim. I confirmed that one claim was incomplete and sent you an email with the details of the claim. Once we receive the amended claim we will process the claim further. Please accept my sincerest apologies for the manner in which your query was handled.
Remember when claims are submitted to the Scheme for re-imbur*****t the claims must include the following information:
o Your membership number
o Patient's name
o Healthcare provider's name
o Healthcare provider's practice number
o Account number
o Treatment date
o Tariff/Procedure/NAPPI codes
o Amount claimed
o Diagnostic code (ICD-10 code per line billed)
Thank you for allowing me to assist with your query.
Kind regards
Jashvir