LL
Lorri-Anne Louis

1 reviews | Active since Sept 2013

03 Aug 2023, 17:06

Discovery not paying for procedures

On the 5/07/2023 I had a mammogram done and results came back that I need to do a Core needle biopsy. I called Discovery on the 6/07/2023 to confirm about this procedure of which Tracy had advised me that the medical aid covers 2 types of biopsy's and the core needle one is one of them. Radiology called me to say medical aid is rejecting the procedure at this moment all I can think about is my health. So I went ahead and made an appointment to go ahead I paid the bill of R9600. Had my biopsy done on the 13/07/2023. On the 15/07/2023 I started submitting my claims(Invoices, paperwork) what a nightmare this journey was poor services at its best I had to call to find out etc what is happening. Claims decided that they will only pay an amount of R4392.94 on the 03/08/2023. Now I would like to know where does it leave me going forward because now I do not have funds for specialists available because funds was paid from there leaves me with a balance of R5207.06 + a Lancet Invoice of R2150.60. Of which on all calls to Discovery I was advised that this procedure is covered. This I find disgusting and makes me wonder what will happen in the future for current emergency procedures.

I would like for Discovery to look into this matter and would like for a full refund of my balance and for the Lancet billed to be paid.

Ref numbers more to provide upon request: *** ,***, ***, ***,

All documents can be provided and had been submitted to the medical aid.

0
Replies (2)
Discovery Health
Discovery Health's reply04 Aug 2023, 07:26
Official
Dear Lorri-anne L

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
Discovery Health
Discovery Health's reply07 Aug 2023, 10:30
Official
Dear Lorri-anne L

We’ve responded to your query. 

Regards Discovery Health Servicing Team