LM
Lesley M

1 reviews | Active since Sept 2016

15 Aug 2021, 07:09

Discovery **********: Takes our money and doesn't pay the medical bills

I was referred to a supplier who Discovery says has been flagged, as such they are refusing to refund the medical expenses I have already paid. I have sent the claim several times and they do not respond. I then completed the special MSA funding request again several times and finally got a call on Friday 5 August at 14h06 which lasted 6 minutes where the gentleman told me that the flag had been lifted and that my claim would be refunded. I received an email this week telling me that the claim will not be paid. I was referred by my GP to this medical supplier. They have provided a very good service and I have received results that have helped in improving my health and that of my family. As such I expect the medical aid to honour the payment and refund my money. This is my medical savings and I should have a say in how I want to spend it. I feel that it is unconstitutional that Discovery does as they please with our money. Even after I have completed the MSA form for other claims, they have refused to pay in full, they refund part of the claim stating the claim was above the amount. Again I say, this is my money and if I had to pay that amount to the Dr, then I expect that amount to be refunded to me IN FULL. They take our money and jump up and down if it is late, but they fall short of being upfront, honest and ethical when it comes to paying. I contacted the supplier to ask if they knew they had been flagged. The accounts lady had no idea they had been flagged. Again this points to dishonesty and cloak and dagger behaviour on the part of Discovery.

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Replies (4)
Discovery Health
Discovery Health's reply16 Aug 2021, 07:17
Official
Dear Lesley M

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

Discovery Health
Discovery Health's reply18 Aug 2021, 18:16
Official
Dear Lesley M

We have contacted you regarding your query.

Regards 
Discovery Health Servicing Team

LM
Lesley M's update19 Aug 2021, 12:59
Reviewer Update
Discovery is adamant that they are not going to pay my claim stating that the provider has been flagged. I can only surmise that it is linked with the clawbacks that were on Carteblanche on the 25th of July and that the poor provider has been audited and that discovery has been Judge jury and executioner against the provider, stopping all payments to them and blocking them on their system stating they are doing this to protect the member. I am the member and all I see is *******ion and unconstitutionality and the member is the one coming off short because we have to pay double.
Discovery Health
Discovery Health's reply24 Aug 2021, 14:42
Official
Dear Lesley M

We have contacted you regarding your query.

Regards 
Discovery Health Servicing Team