JS
Jacobus S

1 reviews | Active since Feb 2019

26 Feb 2019, 23:58

Discovery Medical scheme Claim denied and no feed back of whats going on

I was in a accident December and I dont just run for anything to the doctor or hospital. I phoned my doctor and he was on holiday and I needed medical help. First went to Clicks and they looked at me once and said no I must get medical treatment. So I went after work to Mercantile health after my boss told me I must go. Got there asked a thousand questions. Lady at the desk told me I must fill in forms and then she was on the computer and she told me the medical aid responded and im authorised and good to go. Then I paid R325 co payment. And waited. Untill a nurse came took my blood pressure, tempreture and statement. I went back to wait room and they then called me later and the doctor on stand by with a nurse saw me. I came out and then the first lady at the desk wasn't there but the other lady that took the shift left an E-mail and I asked her my questions about paying any hospital fees and she told me no as long as you paid your co payment. The lady at the desk still owe me my change that I havent received. I went for check up twice and I asked again with friends as witnesses and a different lady told me no as long as I paid my my co payment. Last visit the front desk lady told me again after asking her again and remember " no sir don't worry if you paid your co payment then you are covered and no one ever comes back and pay anything."

I paid my own medicine and paying off my crutches but it takes the cake now

Life Healthcare Hi JACOBUS SADIE, your invoice for your Hospital stay has been generated. Total due R270.29 Regards Life Healthcare

Life Healthcare Hi JACOBUS SADIE, your invoice for your Hospital stay has been generated. Total due R214.94 Regards Life Healthcare

A message from a friend that knows and works with different medical schemes "Hi Jacobus, if you already paid the co-payment for the casualty they should pay the rest"

I followed the steps asked questions and paid co payment and phoned Discovery to find out after I got sms from Mercantile I owe them that my hospital claim was denied. And the info is wrong on the claim. I still wait also for Discovery keycare to phone me back.

Qoute from a pdf file from Discovery keycare plus advert. Keycare plus full cover hospital network, unlimited cover in the keycare hospital network. Casualty visits Cover in any casualty unit at one of the KeyCare network hospitals. You have to pay the first R355 of the consultation. Subject to preauthorisation

All Discovery Health Medical Scheme plans offer unlimited hospital cover. Your hospital cover includes the account from the hospital

South Africa has an AdvertisingStandards Authority (ASA), a self regulating body of the advertisingindustry that has a Code of Ethics and a procedure in terms of which consumers and competitors may lodge a complaint to theAdvertising Standards Authority on a number of grounds, including on the ground of misleading, ...

And I find that im being misled and no one phoned me or told me what is the problem of the claim being denied and friends tell me im being taken a fool. Sincerely

Jacobus Sadie

0
Replies (2)
Discovery Health
Discovery Health's reply27 Feb 2019, 07:39
Official
 
Dear Sadiejacobus 

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

Regards
 Discovery Health Servicing Team 

Discovery Health
Discovery Health's reply01 Mar 2019, 12:33
Official
 
Dear Sadiejacobus 

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

Regards
Discovery Health Servicing Team