JDT
Jeanne-Marie Du Toit

1 reviews | Active since Jun 2013

01 Oct 2015, 10:35

Discovery not paying claim as communicated

I recently went for a procedure. I called Discovery to get authorisation for the procedure, gave the codes provided by the doctor for the procedure to be performed. I was told that I don't need pre-authorisation and I was transferred to another department. I gave this person all the codes again and was told that it is fine my co-payment is R2,750, the rest of the cost would be covered by my savings plan. Reference for this call is ***. When I went for my follow up I was told by the doctor Discovery is refusing the pay another R3000 on the account. I called Discovery (reference number ***) and was told it is due to the codes being used. A day thereafter I was called and told the matter was resolved and the payment will take place Reference number ***. On Tuesday I got a call saying they have still not been paid. I phoned Discovery again reference number *** and was promised feedback yesterday. I still have not received feedback and Discovery is looking for excuses not the pay the doctor. Which is not fair since I was not notified upfront that they will not pay

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Replies (1)
Discovery Health
Discovery Health's reply01 Oct 2015, 13:13
Official
Hello JMduToit1986,

Thank you for your comment.

We are currently investigating and will be in contact to assist.

Regards
Arthi