JJ
J J

1 reviews | Active since Jul 2018

13 May 2022, 11:48

Discovery NOT PAYING for front line health care worker COVID PCR test (after 6 months of trying to resolve issue)

From Discovery Website "Registered healthcare professionals, that are members of Discovery Health Medical Scheme, have access to 4 PCR tests per year. 12. If I suspect I have contacted COVID-19 and go directly to my doctor or a testing station, without completing the COVID-19 risk assessment or a screening consultation, will Discovery Health Medical Scheme still cover the cost of my test? Regardless of the outcome of the test, the WHO Global Outbreak Benefit will cover the COVID-19 screening consultation and PCR test, if referred by a doctor up to the Discovery Health Rate, even if you have not competed the risk assessment."

But, they are refusing to pay for my PCR from 13 December 2022: "Please note that the member was referred by a provider that is not registered with discovery so they must settle the account form their own pocket."

I was referred by my employer, Prof *********, practice number ******x. Nowhere did discovery state that they will only pay if I am referred by "discovery registered provider"

After 6 months, multiple emails, a 20min phone call with "executive office", how discovery still has the audacity to tell me: " Please note that the member was referred by a provider that is not registered with discovery so they must settle the account form their own pocket" I do not know.

It is a really unfair and unprofessional way to treat a front line doctor during a global pandemic. And all of this because of a R500 PCR that they promise on their website to pay for.

0
Replies (4)
Discovery Health
Discovery Health's reply13 May 2022, 12:10
Official
Dear J J

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
JJ
J J's update16 May 2022, 09:58
Reviewer Update
still no response
JJ
J J's update16 May 2022, 10:13
Reviewer Update
No one at discovery can answer my simple question:

1. Nowhere did discovery state that they will only pay if I am referred by "discovery registered provider" I quote the discovery website again:
will cover the COVID-19 screening consultation and PCR test, if referred by a doctor

NOT: if referred by a "provider that is registered with discovery"

So why is discovery not paying??

It says on your website you will.

And has anyone at discovery thought of the implications of not wanting to pay for a PCR from a front line health care worker? Giving him 6 months of admin because of a technical issue, instead of just paying for a R500 PCR. (As a side note: the whole of 2021, at the height of the pandemic, I only asked for ONE covid PCR. I saved discovery money by NOT going to a GP but getting a direct referral... and this is how I get treated) Is this how your company wants to keep clients?


Discovery Health
Discovery Health's reply20 May 2022, 12:59
Official
Dear J J
 
Please check your emails for final feedback from us.
 
Regards
Discovery Health Servicing Team