CW
Cecilia Wynne-Griffith

1 reviews | Active since Jan 2012

23 Sept 2021, 09:10

DISCOVERY- the great Houdini of healthcare- DISappearing with your money, DISappearing with service, DISappear in a maze of communication or the lack thereof

Your firewall blocked the email to the kzn escalations department...so can't wait to hear the new excuses...oh yeah, that's right...Discovery never apologises for anything- what a great bunch they are...

So I won't be wasting my time anymore- I will copy and paste the email below- then between all the different departments- Claims, Dr Noach, the AskDiscovery consultants, The KZN executive Office and the Escalations department as well as the service provider- you can sort it out amongst yourselves. I don't care if you need to invent a new system, create new codes, fire people, hire people, blameshift between departments for ineffective communication- but we are done...

See below the email:

I came across this email in my trash today.

I would appreciate if Discovery would reconsider as I have been trying to settle this since inception...so it is reasonable to think that in fact it has been submitted in time as we've been disputing it since March. Both myself and the service provider has been submitting with codes that were provided by Discovery since March.

As I have mentioned this has been going back and forth and initially it was submitted in time...then there was an issue with codes, then the service provider, JA Louw, had to submit with sports injury benefit codes...which he has done...

And my question remains- why were we not supp**** with a quotation if this would not have been covered in the first place? Everyone said that this would be covered- and I have done everything that Discovery has asked. I am done jumping through these hoops. This has wasted more than a week of my time.

I am not having fun while typing all these emails...there is a reason I started off with claims, then the Ask Discovery whatsapp channell, then I sent a mail to dr Ryan Noach who escalated the matter to the kzn executive office and now its been escalated to the kzn escalations department...surely you can see that there has been a consistent flow of communication from my side and that I have been complying throughout to get this settled.

So please reconsider and perhaps add a receipt notification that Discovery can be sure the client has in fact read the email. The system is very counter intuitive as departments do not communicate effectively.

Suggestion- perhaps a follow-up call would not go amiss as the majority of the complaints are about non-effective communication from Discovery's side.

My original email that was sent to Dr Noach which he escalated- please see below...the initial date was 8 March...which would indicate that it was escalated within reasonable time- and since then there has been communication where the sports injury benefit codes were used etc.

On 12 JULY we asked the service provider to use the sports injury benefit codes as supp****- which they did and resubmitted...

I have attached the invoice AGAIN.

0
Replies (3)
Discovery Health
Discovery Health's reply23 Sept 2021, 10:38
Official
Dear Cecilia W
 
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
CW
Cecilia Wynne-Griffith's update23 Sept 2021, 11:01
Reviewer Update
Yes, although I have received some form of feedback from the escalations team- please see below my response to all involved:

Although I have read and understood your reply it does not mean that I will not dispute it.

Why was the previous reason for the rejection of payment that it was not submitted in time, but this time the reason is that the member's plan does not cover it? Why did previous excuses include that the sports injury codes were wrong? Where on the plan does it state this- everything in hospital should be covered? Why were we told by everyone that this would be covered?

How is it possible that depending who you speak to on the day you get a different set of replies? Surely there must be one line of communication...it took months of back and forth to settle the previous accounts because of the exact same issues. So please copy and paste where the plan states that this is not included in the plan...also please explain to me- if everyone knew from the start that this would not be covered why we were not first given a quotation?

This is as ridiculous as the first time I contacted Discovery regarding the same issue- In future I will record everyone's responses- the one that states it will be covered when in fact it's not will then have to settle the bill. Perhaps health professionals, brokers and Discovery staff will then very carefully reconsider before just randomly stating that "everything will be covered". I have also given a solution to this problem in a previous email.
Discovery Health
Discovery Health's reply28 Sept 2021, 13:57
Official
Dear Cecilia W
 
We’ve responded to your query.
 
Regards
Discovery Health Servicing Team