AS
Aslam S

1 reviews | Active since Feb 2017

03 Feb 2017, 20:42

Discovery keycare

<p>Att Shanna Singh</p> <p>As per our telephonic conversation you told me a few things which I remember <br />1) you giggled at my situation <br />2) you called my complaints silly <br />3) you made it sound as if I never knew anything about keycare</p> <p>Than you said no all specialists will be paid as long as you get your gp to fill in a specialist form and get approval from discovery</p> <p>Did all of it !!!</p> <p>Discovery Health Medical Scheme: Your visit to the specialist (Rosman K D) is approved. It will be paid from your available Specialist Benefit limit, including approved blood tests, X-rays and the medicine on the medicine list. Use reference No. ********** 2 when you make the appointment: valid from 2017-02-01 to 2017-03-03. Call us for an authorisation number if you are admitted to hospital</p> <p>And below is the email I get</p> <p>I am now sure going to media for bad service and no help with someone in need of medical equipment or sleep apnea test and being refused than no doctors got paid as you said I never went through the proper channels <br />And you said if I follow protocol</p> <p>NOW EXPLAIN BELOW</p> <p>I want a copy of the recording of our conversation in dec 2016</p> <p>Also I am adding this to HELLO PETER etc</p> <p> </p> <p> </p> <p> </p> <p>Sent from my iPhone</p> <p>Begin forwarded message:</p> <p>From: ********** />Date: 03 February 2017 at 4:49:14 PM SAST<br />To: ********** />Subject: We have received and assessed your latest claim(s) -MailRef# ********** 721#-</p> <p><br /> <br /> ********** </p> <p>Dear Aslam</p> <p>This email contains details of your most recent processed claim. You will also see how this impacts the status of your day-to-day benefits, which includes a breakdown of limits used in this benefit year.<br /> <br /> <br /> <br /> Summary of your claims<br /> <br /> <br />Neurologist Rosman K D<br />Claimed R850.00 claimed for date of healthcare service 2017/02/01<br />Paid to No payment.<br /> <br />Click here<br />for more information<br /> <br /> <br /> <br />Limits apply to certain benefits. We pay day-to-day benefits from your Medical Savings Account or Above Threshold Benefit up to the limit that applies. Refer to your Health Plan Guide or go to www.discovery.co.za for a list of limits that apply to you.<br />Report irregular or ********** claims. Email ********** To stay anonymous, call our ***** Hotline on ***or email ********** When sending through a report, please include your membership number and the details of the claim you are querying.</p> <p><br />New voice biometric system will give you absolute caller convenience<br />In a first for the South African healthcare industry, you now have access to voice biometric technology. After enrolling by simply recording a phrase four times, the biometric system will use the distinctiveness of your voice to instantly verify your identity whenever you contact the call centre in future. Your information is kept confidential. Among its benefits, it will secure your identity and save you time as you will no longer have to answer security questions for us to access your details. Register today.</p> <p>Take part in your care<br />Knowing about your illness and taking part in the care your doctor offers can help to increase the effectiveness of your care.</p> <p>Follow these tips to help you be fully informed so that you can work with your doctor to make sure you’re part of your care, especially when you need to make some important decisions.</p> <p><br /> <br /> <br /> <br /> Claim details for Rosman K D<br /> <br /> <br />The 'Payment details' section below gives you a breakdown of each claim from your healthcare professionals. This section tells you who was paid and also shows whether the claim was paid from your Medical Savings Account or from the Scheme.</p> <p>Payment details</p> <p>Amount paid Payment to Payment from Payment date<br />No payment - refer to claim detail below<br /> <br />The breakdown below shows you each claim that we processed from your healthcare professionals. To protect your confidential information, it does not include clinical or diagnostic information.</p> <p>Below is a breakdown of information from each part of the claim.</p> <p><br /> Amount payable<br />Date of healthcare services Patient name Amount<br />claimed Scheme Rate To you To the healthcare professional Reason Code<br />2017/02/01 Aslam R850.00 R513.60 R0.00 <br />R0.00 <br />733<br /> <br />733 We have not paid the amount on this line as we need the date of service to pay it. It either did not show on the claim line or may have been unclear on the copy we got. Please resend an original claim.<br /> Previous page<br /> <br /> <br /> <br />To change the email address this notice goes to, please log in to the website and change your email address under "Update your details".</p> <p>Please click here if you don't want to receive an update each time we process one of your claims. Remember, we don't send monthly statements anymore. If you cancel this service, there'll be no communication to keep you updated when we handle your claims.</p> <p> </p> <p>Disclaimer<br />This message and any attachments are confidential and intended solely for the addressee. If you have received this message in error, please notify Discovery Health Medical Scheme immediately, telephone number ***. Any unauthorised use, alteration or dissemination of the contents of this email is strictly prohibited. In no event will Discovery Health Medical Scheme or the sender be liable in any manner whatsoever to any person for any loss or any direct, indirect, special or consequential damages arising from use of this email or any linked website, including, without limitation, from any lost profits, business interruption, loss of programmes or other data that may be stored on any information handling system or otherwise from any assurance that this email is virus free even if Discovery Health Medical Scheme is expressly advised of the possibility of such damages. Discovery Health Medical Scheme (registration number 1125) is a registered medical scheme.</p> <p> </p>

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Replies (3)
AS
Aslam S's update04 Feb 2017, 14:06
Reviewer Update

Hi

To whom it may concern

I am looking at the letter sent but I am not happy with this result because as this plan continues I keep paying for doctors and specialists. I even had to now buy this machine by taking out a loan to pay for it . I really don't see why I should than have this medical Aid. The medications I don't want to be paid only the test for sleep apnea and the machine, by the looks of things I will have to speak to my broker to change me to another medical Aid brand and I really think Discovery doesn't care about there customers to assist . I mean the doctor gave a letter stating the life threatening situation that can cause an accident or heart attack or stroke. I really don't see how you cannot look at this as not serious,

I am sure social media and the media would like to know how this has been handled and people health don't matter

When I app**** there was a waiting period because I had sinus related issues and I never claimed for that as it's an exclusion. I paid cash to have the sinus op done, I paid cash to stay in that hospital, I paid cash as I went to see 3 ENT specialists a palmonologist, heart specialist, CAT SCAN , blood tests etc I did all this and now for something that has been newly discovered my medical Aid won't pay is ridiculous


I hope someone reads this as I am disappointed

Sent from my iPhone

On 03 Jan 2017, at 3:22 PM, ********** wrote:

Dear Aslam

Thank you for your application for funding. The attached document explains our decision.

How to open the attached document

You will need Adobe Reader installed on your computer. If you do not have it, please download the Adobe Reader software or copy and paste the following URL address in the address line in your web browser: http://www.adobe.com/products/acrobat/readstep2.html

Regards

Dr Ryan Noach
Deputy Chief Executive Officer
On behalf of Discovery Health Medical Scheme

Discovery Health
Discovery Health's reply06 Feb 2017, 09:07
Official

Dear Aslams85

We’re sorry to hear that you are dissatisfied. We’ll investigate your concerns and contact you again once we have completed the investigation.

Regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply06 Feb 2017, 12:29
Official

Dear Aslams85

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

Regards
Discovery Health Servicing Team