LC
Lauren C

1 reviews | Active since Aug 2009

17 Jun 2022, 14:46

Discovery reversing and not paying a preapproved claim

Discovery paid a hospital claim for me plus a portion of the specialist. All bills were settled in full by both discovery and myself then my gap paid me back the balance. I then 3 months later received an sms from the doctors rooms stating an outstanding amount that Discovery reversed without notifying me! I phoned them and they told me it was an error however the claim was approved upfront (in hospital procedure) and processed and paid by them. How can they just change their mind? Now I can’t claim the amount from my gap cover and because discovery has reversed a portion of the claim which was pre approved, the gap cover is Giving me a hard time. This puts in a very difficult place financially and I can’t believe discovery can get away with this! A pre approved claim, paid and then reversed months later?? That was supposed to be for discovery’s account. I am thinking about changing my medical aid and cancelling my discovery credit card because of their actions. Large corporate just doing whatever they want!

0
Replies (5)
Discovery Health
Discovery Health's reply20 Jun 2022, 07:19
Official
Dear Lauren C

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 reply21 Jun 2022, 17:57
Official
Dear Lauren C
We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team
LC
Lauren C's update24 Jun 2022, 15:14
Reviewer Update
Hi this has still not been resolved
LC
Lauren C's update28 Jun 2022, 14:00
Reviewer Update
This has still not been resolved, and because of discovery’s error my gap cover is telling me I have to pay them back over R2300 so now because of discovery’s error I have to pay R2300+R1100 this is disgusting treatment of a customer and I will have to consider moving my medical aid as well as cancelling my discovery credit card as I do not wish to deal with a company who does not care. This treatment shows discovery does not care about its customers. They just want money and to find any reason not to pay. I have pre authorization evidence from discovery for this procedure, it’s shocking
Discovery Health
Discovery Health's reply01 Jul 2022, 12:03
Official
Dear Lauren C
We have been in touch with you to answer your comments and we are investigating your query further. 

Regards
Discovery Health Servicing Team