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traceysteinhobel T

1 reviews | Active since Jan 2015

13 Aug 2018, 09:13

DISCOVERY KEEPS REJECTING CLAIM THEY HAVE ALREADY PRE-AUTHORISED!!

I am a member of Discovery Health and as part of my maternity plan, I met the required criteria for the NIPT tests.

As per the Discovery requirements, I emailed the NIPT department with the required documents and received an official reply on 27/07/2018, advising that my request had been approved and an approval reference number was provided. Approval reference number: ********** 862.

Upon submission of my claim on 02/08/2018, Discovery rejected my claim. On 03/08/2018, I followed up by telephone and spoke to consultant Lindiwe. She promised this would be sorted out in 2-3 days and would personally follow up and contact me. Reference number with Lindiwe: ********** 766.

Lindiwe failed to follow up and failed to contact me. My claim is rejected again.

On 07/08/2018, I followed up AGAIN by telephone and spoke to consultant Siya. I relayed my reference number from when I spoke to Lindiwe. Siya advised that Lindiwe was supposed to follow up and escalate the matter, but did not. Siya said Lindiwe was supposed to file this as a systems error but didn't and instead erroneously sent the claim to pathology where it was rejected again. She promised this would be sorted out in 2-3 days. Reference number with Siya: ********** 071.

On the same day, I spoke to Siya's supervisor, Danny Jacobs. Danny assured me she would attend to the matter and escalate it and would come back to me by either 08/08/2018 or 10/08/2018.

Surprise surprise! Both Siya and Danny Jacobs failed to follow up and failed to contact me. My claim is rejected again.

WHY IS DISCOVERY MESSING ME AROUND ON A CLAIM THEY HAVE ALREADY PRE-AUTHORISED! I HAVE FOLLOWED UP 3X AND MY PRE-AUTHORISED CLAIM IS STILL BEING REJECTED!

WHAT DO I NEED TO DO TO SPEAK TO SOMEONE AT DISCOVERY THAT CAN ASSIST, AND THAT CAN ACTUALLY FOLLOW UP WITH AS PROMISED AND SORT THIS OUT!!!?

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Replies (7)
Discovery Health
Discovery Health's reply13 Aug 2018, 09:39
Official

Dear tracey157

We’re sorry to hear you’re dissatisfied. Please give us a chance to look into your query and we’ll be in touch soon.

Regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply15 Aug 2018, 10:19
Official

Dear tracey157

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

Regards
Discovery Health Servicing Team

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traceysteinhobel T's update30 Aug 2018, 18:49
Reviewer Update
AS AT 30/ 8/2018, THIS MATTER IS STILL NOT RESOLVED!!
Discovery Health
Discovery Health's reply31 Aug 2018, 10:49
Official

Dear tracey157

We’re sorry to hear you’re dissatisfied. Please give us a chance to look into your query and we’ll be in touch soon.

Regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply03 Sept 2018, 14:15
Official

Dear tracey157

Please check your email inbox for our final feedback.

Regards
Discovery Health Servicing Team

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traceysteinhobel T's update06 Sept 2018, 10:23
Reviewer Update
I have emailed Preeti Mocktar requesting some information and assistance and am not receiving a reply. It is very frustrating that there is no available phone number or email address to contact the people like Preeti Mocktar who have promised to help. Please can Preeti Mocktar pleasereply to my email or phone me as I am trying to reach her and she is not responding.
Discovery Health
Discovery Health's reply10 Sept 2018, 10:30
Official

Dear tracey157

Please check your email inbox for our final feedback.

Regards
Discovery Health Servicing Team