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Frances B

1 reviews | Active since Nov 2022

15 Nov 2022, 17:20

Discovery Not Paying According to their own schemes.

1. Discovery sent me correspondence for about 6 weeks regarding a PMB form for a medical aid claim. When I enquired about the claim status at the call center, I was told there is not claim registered on their system. 2. After using the Discovery Hospital Network as per my plan, Discovery is declining all my claims relating to a sports injury (included in a Classic Smart). 3. Not my broker, or a claims consultant informed be that a Discovery GP must activate the benefit until about a month after I initiated the original claim. The GP cannot set the date for the injury, even though multiple hospital, specialist and radiology reports all list the same original date. Discovery Claims they cannot change this date according to the existing medical reports. 4. Claims for after the date initiated by the Discovery GP have now been declined. 5. No manager at the call center will take my calls when i phone because "they are too busy"

I just want some help.

0
Replies (7)
Discovery Health
Discovery Health's reply16 Nov 2022, 06:57
Official
Dear Frances B

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

FB
Frances B's update17 Nov 2022, 13:51
Reviewer Update
Hi Discovery Servicing Team

Your claims team is now saying that my ER visit (on a Saturday afternoon around 4:30 for a open fracture in a Smart Network Hospital) does not count as a GP visit. I have sent my ER discharge papers, with radiology reports, but apparently the only proof that will be considered is an additional claim for the ER visit, which seems like strange advice as ER cover is not accounted for in my scheme (Classic Smart).

Additionally, when I ask to escalate to a manager, I receive no contact from someone with a higher level of authority.

And lastly, Discovery has app**** an incorrect date to my sport injury and will not correct it, even though I have supp**** clinical documentation supporting the date of injury. I have insisted that I do not accept this date and that my acceptance would be insurance *****.

Please can someone with the correct level of authority and clinical expertise contact me or come see me in person.
Discovery Health
Discovery Health's reply18 Nov 2022, 13:26
Official
Dear Frances B

We have been in contact with you.

Regards 
Discovery Health Servicing Team
FB
Frances B's update30 Nov 2022, 10:25
Reviewer Update
@Discovery, please can you have someone competent contact me? It honestly feels like you guys are just delaying me with paperwork to get to the 4month mark so you don't have to pay me back for a PMB. Apparently a radiology report confirming a broken bone is now not enough. Your broken and PMB team are requesting "the amount or size of the fracture". It's honestly just not good enough.
Discovery Health
Discovery Health's reply02 Dec 2022, 14:39
Official
Dear Frances B

We have contacted you.

Regards 
Discovery Health Servicing Team
FB
Frances B's update05 Dec 2022, 14:56
Reviewer Update
Hi Discovery Team

I had a medical emergency in September. I submitted a claim for the treatment in September, but the valid dates from your Team reads "December 2022 to March 2023" with no explanations.

You guys actually have not contacted me at all. The only contact I have with Discovery is everything I initiated.

I really, really just need clear communication and help.

Kind Regards
Discovery Health
Discovery Health's reply08 Dec 2022, 15:27
Official
Dear Frances B

We have sent you an updated letter.

Regards 
Discovery Health Servicing Team