MW
Marie W

1 reviews | Active since Mar 2019

25 Jan 2022, 11:10

Discovery Health not very keen to pay claims members paid out of pocket.

My daughter had a dental procedure which had to pay for out of pocket and claim it back from Discovery medical aid. On 14 January 2022 I send through the documentation via email. On the following Tuesday I followed up because I received an email stating it would take 2 to 3 working days for my claim to be paid out. I was only then notified that the attachment wasnt attached when the email arrived on their side. I send through another batch of documents. I phoned them and they confirmed that they did receive the email with the attachment. The agent opened the document and checked and confirmed that everything was in order. I phoned on Wednesday to check up and was informed that my claim could not be processed because the procedure date on the line items were cut off, even though the same date were on the top of the documents. I send through another batch of documents. I phoned to confirm that everything was in order. And was told that everything was ok. Email said that it takes 2 to 3 working days for claim to be paid. On Thursday I phoned to check up and was told that the claim was processed on the wrong date. I send through the documents again. On Friday I was told that may claim was captured on 19 Jan 2022. I was told that It was released on 21 Jan 2022. What does this actually mean, because on Monday 24 Jan I was told that it will be paid and released on Monday 24 Jan 2022 to reflect on Tuesday 25 Jan 2022. On Tuesday 25 January I was told that it was only paid today and will take 2 to 3 working days to reflect. After telling the agent that I was told the payment will reflect today she said the best she can do is to get a letter stating he money has been paid. Its been 11 days after the initial email stated it will take 2 to 3 working days. After that everybody climbs onto the 2 to 3 working days bandwagon. There is no way for me to follow this up except to phone the call centre. Its virtually impossible to speak to the same agent again. I have spend almost R400 in phone calls to discovery. All the agents promise to phone back. None of them do actually phone you back. The claim cant be tracked on the app. The agent cant give me proof of payment either. Everybody I speak to will investigate and get back to me. That never happens. All of this to get my own money back.

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Replies (2)
Discovery Health
Discovery Health's reply25 Jan 2022, 12:41
Official
Dear Marie W

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 reply25 Jan 2022, 14:16
Official
Dear Marie W

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team