YM
Yan M

1 reviews | Active since Mar 2019

25 Mar 2019, 13:30

Discovery Health - Sports Injury Benefit - failed claims and failed service

I joined Discovery Health and specifically the Classic Smart Plan so that I could do at least 4 physiotherapy sessions, provided I pay a R100 co-payment fee when activating the sports injury benefit with a Network GP.

I had the benefit activated, with an email coming through saying that it has been approved (because approved means that I can take my sports injury benefit to a physiothe****** in the network and get my treatment, right?)

I go and do my physiotherapy session on the 1st of February 2019, and the system kicks out the injury codes, which I will repeat, were approved by the Discovery sports injury benefit system, meaning I cannot claim for the session, pay my R100 co-payment and schedule my next physio session, which I have to be very observant for, as I do only have four sessions in the year that are covered by this plan.

Fast forward later with MANY interactions with various Discovery Health consultants, I still have not received my claim back (as of today the 25th March 2019) for my session on the 1st February 2019.

I have sent this information to the Council of Medical Schemes to take this further, and even they haven't responded to my complaints 12 days later.

I am sick and tired, and in pain from this injury that I want to sort out, but cannot afford to go for physiotherapy sessions, paying in cash and expecting Discovery to pay out every three (or even longer) months.

Is there any medical aid where I do not have to go through hoops and hoops, odds and ends, just to receive the treatment I was promised I would get when joining this Medical Aid over a year ago for this specific reason?

0
Replies (4)
Discovery Health
Discovery Health's reply25 Mar 2019, 14:17
Official
 
Dear yanaungmaw 

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 reply28 Mar 2019, 15:09
Official
 Dear yanaungmaw 

We have been in touch to answer your comments. 

Regards
Discovery Health Servicing Team 
YM
Yan M's update29 Mar 2019, 08:52
Reviewer Update
I will be awaiting the claim return and the fix for the sports injury benefit.
YM
Yan M's update09 Apr 2019, 10:20
Reviewer Update
I require an update on my sports injury benefit codes and which ones I can use, since Discovery does not contact me when they say they will.