Discovery *********** Staff and Complaints Department

Discovery, how do you employ staff that are ***********? Your staff does not know how to submit claims with the correct ICD codes

I had an accident that fell under the PMB S91.0. According to CMS this must be allocated according to the CMS guidelines. Your *********** claims staff loaded the entire claim incorrectly, which came to my attention when I received invoices from SP's advising of outstanding amounts as my "savings have been depleted".

So, I had to call Discovery to find out what is going on. Refiloe assisted me and was the only person who was pleasant to work with and actually listened, was Refiloe.

I lodged a complaint after this. The consultant that I dealt with was rude and not customer service-orientated at all. He made excuses that PMB claims must be reviewed retrospectively and referred to the decision committee. What a load of BS. He was not able to answer any of my questions and this left me with doubt that the matter will be sorted.

Later that week the same person called me back confirming that all invoices, and any other invoices relating to my accident, would be paid in full. Still rude and no apology for the inconvenience caused.

But guess what, there are still accounts not paid. And again I have to follow up with Discovery.

Being in the Customer Services industry, the level of service received is absolutely appalling.

This is the second time that I had a PMB claim with Discovery that I had to go through the same BS to get it paid.

Where do Discovery's values reflect in this entire ordeal? I have been patient and given Discovery more than enough time to rectify their mistake.

If this matter is not resolved by 9 August, I will escalate this to CMS.