1 reviews | Active since Apr 2015
Discovery wake-up
I submitted my claim 14.04.2014 for my dentist's services, claim was paid and later reversed with no explanation. Numerous telephone calls and several e-mails were sent to various departments as instructed by Discovery consultants with no avail. Only promises of clueless agents who were passing back from one to another not willing to sort out my query. They gave me or my wife reference number and promise, answer to e-mail with all standard phrases and repeating them as parrots. Client relations manager (could give name and all others) admitted that my claim is fully legitimate and that he will bring it to conclusion, however the following week he was moved to the other department. I had to start process again, wasting my time and money. I am member of Discovery Medical Aid since 1998 and this kind of service from Discovery Health is totally unacceptable. This kind of ignorance and unprofessional conduct I did not experience from Discovery all these years but in 2014 there were a couple. Hey Discovery wake-up! Today is 15.04.2015, full year after my first claim and I am still waiting. Do not forget that we, members are paying your salaries in this difficult economic conditions!
Thank you for allowing us to assist you.
As confirmed, we received a claim from you dentist date 2014/04/14. Initially we paid an amount to you and this payment was made on 2014/04/17.
On 2014/04/30 our Risk Management Team ran a report through the system to see if there are any claims from dentists billing incorrect codes for certain tooth numbers. Your claim was identified and reprocessed. We reversed two codes as these codes were billed for an inappropriate tooth number.
Due to the amount already being paid to you, there was a negative amount created on your statement.
We require an amended account with the appropriate tooth numbers for this service. Please feel free to forward the amended account to me directly in order for me to facilitate the reprocessing of your claim.
I would also like to take this opportunity to apologies for any inconvenience you have experienced in this regard. I will discuss this with the relevant managers to avoid any re-occurrences of this nature.
Kind regards
Danita
Thank you for allowing us to assist you.
As confirmed, we received a claim from you dentist date 2014/04/14. Initially we paid an amount to you and this payment was made on 2014/04/17.
On 2014/04/30 our Risk Management Team ran a report through the system to see if there are any claims from dentists billing incorrect codes for certain tooth numbers. Your claim was identified and reprocessed. We reversed two codes as these codes were billed for an inappropriate tooth number.
Due to the amount already being paid to you, there was a negative amount created on your statement.
We require an amended account with the appropriate tooth numbers for this service. Please feel free to forward the amended account to me directly in order for me to facilitate the reprocessing of your claim.
I would also like to take this opportunity to apologies for any inconvenience you have experienced in this regard. I will discuss this with the relevant managers to avoid any re-occurrences of this nature.
Kind regards
Danita