1 reviews | Active since Jan 2020
Discovery misleading their members - false info on website
On December 2019 our medical savings funds were exhausted but we still had 4x family consultations left as per the Day-to-Day Extender. As we are on the Essential Delta Saver plan we were told at the Discovery presentation that we are only allowed to visit doctors from the Discovery list of network doctors. I consulted the Discovery website for the list of GP doctors when my husband need to see a doctor (because our regular doctor was already on leave) during our Day-To-Day Extender period. I contacted the practice from one of the doctors on the Discovery list of network doctors and the receptionist at the practice said that the initial doctor will not be available but a locum doctor will be able to assist us and I asked her if Discovery will still pay for the consultation (seeing that I did everything I was told at the presentation in getting a doctor from the Discovery network list of doctors) to which she stated that they will because the locum doctor will use the same practice number. After our consultation we were informed that Discovery will not be paying for said consultation and we made a cash payment to the practice. I submitted a claim last week to Discovery for the refund of R455.90 to which they stated "the doctor is no registered as an associate on day–to-day extender and thus will not be refunded. Not all doctors are registered as associates therefore member should contact us or Discovery first to check doctors that are active on the network hence they asked for cash payment. The doctor is on various network arrangements with Discovery, however the doctor is not on the Day-to-Day Extender benefit network and therefore the claim will not be refunded" Nowhere does Discovery mention that members should also call them for confirmation if a doctor is registered or not as network doctor after the said doctor is found on the list of network doctors as per their website!!!! What use is the list of network doctors then on the website if it is meaningless???? Discovery is deliberately misleading their members! Always ready to receive their monthly installments due but never ready to refund a member that followed all required steps to ensure a claim gets paid!!!!!!!!!
