Discovery Health Nonsense

Is Discovery Health still paying claims???? We were send to a specialist on 16 November 2019 being a referral. Paid Cash because the Specialist didn't want to deal with Discovery anymore. See his emails below. So paid cash and send the claim to Discovery. Discovery said they are paying only R682.00 out of the R3600. Reason given being "Prolonged face-to-face attendance to a patient". Seriously a Dr refers you to a specialist to go and have prolonged face to face interaction that will cost you R3600??? As though that's not enough, they said they can only pay the claim from 2020 MSA so a form needed to be completed which we did. Send in the form and 2 weeks still no refund made. Every time I call there is something different they have to say. Sometimes I am told the money has been released, I call the next day someone says the money hasn't been released. This whole week I called everyday to a new story. I send another claim for 30 Jan 2020, an automatic response says "Dear Member Thank you for your email. This is an automated response to acknowledge receipt of your claim(s). Your request will be processed within 2-3 working days. Your reference number is ***, and the details of these claims will reflect on your next claims statement or notification. Please do not reply to this email." The claim was send on 31st Jan 2020. I don't want to count the number of days it has been now. I speak to lots of people and its empty assurances every time. Is there any reason for panick????

See the emails from the Specialist below, Thank you for your email. I have checked my account from October 2019 to today and unfortunately I cannot locate that particular payment (Please ask them to give you the exact date they made such payment). I am afraid but this is not the first time Discovery has given a statement to a patient claiming to have paid us only to change the story later . I have traces of emails with them about this unprofessional and ********* practice.

Does it make sense to you that you submit a claim using an invoice that is clearly written' THE PATIENT HAS PAID PLEASE DO NOT PAY THE DOCTOR' but yet they pay someone who did not claim? What type of normal business does that? Would you?

I am willing to recheck if they can give you specific date the payment was made. Last time they did the same and when contacted told us they were still going to pay.

The fact that the story keep changing each time should worry you as a client.

Will recheck if they can tell you when they paid as I did not see that payment between Oct 2019 and today.

2nd email

I will check again over the weekend but this is not the first time Discovery did something like this , you can ask Kagiso. The lies that goes out there is shocking for a professional institution. I told them that I will report them to the CMS if they continue to create unneccessary tensions between us and our patients. You will recall there was one a time where no doctor wanted to see a Discocery patient. I know doctors are considering this once more while others have started.

Will let you know if I so pick the payment. They should send me an email and notify me of the incorrect payment knowing that I did not claim instead of wasting your time. Discovery is known for recovering incorrect payment. Why not this time.

Doesn't make sense.

This is nonsense coming from Discovery Health.