LM
Lesley M

1 reviews | Active since Sept 2016

15 Jan 2022, 12:20

Discovery refuses to pay PMB claims, ********* medical aid.

Discovery refuses to load PMB conditions making us jump through hoops and doing things that are unnecessary just so they don't have to process the claim. My son was admitted into hospital for a bee sting where he had a severe reaction. I sent through the information the very next day and requested that they upload the condition as a PMB as the Dr said we needed to carry an EpiPen. The ICD 10 code used, T78.4 Allergy unspecified, indicates this, but Discovery wants the Dr to write a report of the signs and symptoms when the script clearly indicated that he had to carry an EpiPen on his person at all times. You would think that this would be enough information for them to work on. I have sent through the bill I have sent through the GP indicating on Discovery's forms that he has a bee allergy, but still this is not enough. They request that we must tell them in detail his signs and symptoms on admission ad get a report from the admitting Dr. so that they can drag their heel and possibly not pay the claim. This is *******ion. They are only too eager to take our money but when it comes to paying the bills they have all kinds of excuses.

0
Replies (2)
Discovery Health
Discovery Health's reply17 Jan 2022, 07:33
Official
Dear Lesley M
 
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 reply17 Jan 2022, 15:28
Official
Dear Lesley M
 
We have been in touch to address your concerns.
 
Regards
Discovery Health Servicing Team