CW
Christine W
1 reviews | Active since Sept 2015
21 May 2024, 15:03
Discovery "Un"Health
Mother in her 80's. Serious heart procedure, Approval given "in error", finally approved less than 2 days before procedure. We were instructed by hospital ICU around 11.30am 4 days post up telephonically to have her collected within 1 hour or else it would constitute an extra day, which would be for our pocket (east rand to west rand), this we did. Since then my mother is receiving account after account not paid by Discovery Health, including x-rays, blood work, the entire ICU stay, care, meds etc., the anesthetist etc. Surely these forms part of the pre authorization/care manager basket. It was also met with resistance by Discovery Health when we tried to have the treating surgeon's post op follow up pre authorized. Disgracefully, inefficient, upsetting and distressing
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Replies (6)0
Replies (6)
Discovery Health's replyOfficial
22 May 2024, 06:41Dear Christine 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
Discovery Health's reply22 May 2024, 06:41
Official
Dear Christine 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
Discovery Health's replyOfficial
22 May 2024, 16:52Dear Christine W
We have been in touch with you to answer your comments.
Regards
Discovery Health Servicing Team
Discovery Health's reply22 May 2024, 16:52
Official
Dear Christine W
We have been in touch with you to answer your comments.
Regards
Discovery Health Servicing Team
CW
Christine W's updateReviewer Update
22 May 2024, 19:02A discovery client liaison officer has been in touch. Said person displayed empathy, and understanding. The reasons for claim rejections (despite receiving pre authorization in writing before hospital admittance, test, surgery etc.) is mainly due to the nature of the procedure, pretty much system driven declines. An alarming, distressing, flawed system to say the least. Accounts are being "re"processed.
Liaison officers team we would like to think will make this a priority. Shouldn't have to call Discovery every time a demand for payment by the member (my supposed to be recuperating octogenarian mum) is sent out by Discovery Health, and be told they'll resubmit claim, to be looked at. Over and over we phone about the same accounts
Liaison officers team we would like to think will make this a priority. Shouldn't have to call Discovery every time a demand for payment by the member (my supposed to be recuperating octogenarian mum) is sent out by Discovery Health, and be told they'll resubmit claim, to be looked at. Over and over we phone about the same accounts
CW
Christine W's update22 May 2024, 19:02
Reviewer Update
A discovery client liaison officer has been in touch. Said person displayed empathy, and understanding. The reasons for claim rejections (despite receiving pre authorization in writing before hospital admittance, test, surgery etc.) is mainly due to the nature of the procedure, pretty much system driven declines. An alarming, distressing, flawed system to say the least. Accounts are being "re"processed.
Liaison officers team we would like to think will make this a priority. Shouldn't have to call Discovery every time a demand for payment by the member (my supposed to be recuperating octogenarian mum) is sent out by Discovery Health, and be told they'll resubmit claim, to be looked at. Over and over we phone about the same accounts
Liaison officers team we would like to think will make this a priority. Shouldn't have to call Discovery every time a demand for payment by the member (my supposed to be recuperating octogenarian mum) is sent out by Discovery Health, and be told they'll resubmit claim, to be looked at. Over and over we phone about the same accounts
CW
Christine W's updateReviewer Update
27 May 2024, 09:04We have received have no communication from Disc since client liaison office telephoned 22 May, apart from e mails pretty much telling us what Discovery Health is not paying, including an almost R400 000 account for the TAVI procedure 8 May and subsequent ICU hospitalization! A procedure that was approved by the "TAVI Team" on 6 May. I keeping calling them. Excuse after excuse, "exception", rerouting etc.
CW
Christine W's update27 May 2024, 09:04
Reviewer Update
We have received have no communication from Disc since client liaison office telephoned 22 May, apart from e mails pretty much telling us what Discovery Health is not paying, including an almost R400 000 account for the TAVI procedure 8 May and subsequent ICU hospitalization! A procedure that was approved by the "TAVI Team" on 6 May. I keeping calling them. Excuse after excuse, "exception", rerouting etc.
CW
Christine W's updateReviewer Update
04 Jun 2024, 14:02The almost R400 000 hospital account remains unpaid. Fast approaching one month since date of service. Still Discovery remains ambivalent, and quite frankly arrogant. I wonder what will happen if the account is not paid within the time fame penalties are charged, who will be responsible for the interest.
Hellopeter spurred a case manager to call me the very next day, nothing since from Discovery's side, except e mails informing us the account they are not being paid. I call almost every day, for hours. Disgusting!
Hellopeter spurred a case manager to call me the very next day, nothing since from Discovery's side, except e mails informing us the account they are not being paid. I call almost every day, for hours. Disgusting!
CW
Christine W's update04 Jun 2024, 14:02
Reviewer Update
The almost R400 000 hospital account remains unpaid. Fast approaching one month since date of service. Still Discovery remains ambivalent, and quite frankly arrogant. I wonder what will happen if the account is not paid within the time fame penalties are charged, who will be responsible for the interest.
Hellopeter spurred a case manager to call me the very next day, nothing since from Discovery's side, except e mails informing us the account they are not being paid. I call almost every day, for hours. Disgusting!
Hellopeter spurred a case manager to call me the very next day, nothing since from Discovery's side, except e mails informing us the account they are not being paid. I call almost every day, for hours. Disgusting!
Discovery Health's replyOfficial
04 Jun 2024, 15:15Dear Christine W
We have been in touch with you to answer your comments.
Regards
Discovery Health Servicing Team
Discovery Health's reply04 Jun 2024, 15:15
Official
Dear Christine W
We have been in touch with you to answer your comments.
Regards
Discovery Health Servicing Team