AK
Andries K

1 reviews | Active since Nov 2017

23 Jun 2022, 09:41

Formal complaint . Unable to get invoice SAOPA code- althou a decision letter 19 June granted full payment ( incompetencey of department s

Good morning o would like to log a formal complaint that forward to Adrian Gore office aswell. Reason mentioning f his office . Seeing that I have been dealing with his office since 7 March and had great personal assist which relates to this master . Which unfortunately is turning into a formal complaint . Seeing that nobody since Monday 13 kjunr has been able to actual perform their duties . That they are employed for . Here the short fact . Recently I have had a huge struggle to get … PLEASE NOTE the words in Bracket …( ( special applicants approved under a unusual ) which with the help of a greatperson Mr Sebonel Nigdi. Went out of way to assist . Both him and I work together to ensure that a question with CORRECT !!!’ Correct!’ SAOPA/Nappi optometrist codes are provide for discovery REVIEW panel . When access my application . That being said it was Approved !!m 10 June 2032 . I received s Decision letter ! 10.06 or optometrist - Even mrMr Nigdi was copied into the decision e mail Which indicate 100../. Full payment of R116923 .00 As per quote 980 Mail ref ***. 10 June - quote 980. Take note of this number Was listing the correct SAIPA/nappi codes . On 13 June the optometrist sent s mail from *** to discovery with invoice form payment .’- a mistake was made by them when mail was sent .

A As per decision letter the (?invoice ref 9cm8ch ) was to be sent and paid by a Dept called Ruleexceptionpayment@ discovery .co.za But unfortunately in ERROR ! it sent first that morning to PMB_APP_beneit Which I know will not cover this invoice . As it not part of my pmb benefits in general ( glasses)

- As a special ( note word pls ) soeciaial review panel at Duscovery had consider a excep request to cover the g cost if my vital !!spectical to be able to have basic sught 24/7

- unpince my becoming aware the optometrist sen it to wrong e mail . They reworked the invoice *** to ruleexceptionpayment dept as per its statement Ed on decision letter second pge marked in blue

- PLease locate the decision letter!! aswell the invoice 8cm8ch !

Dated 13 June on my profile .

- If t you compare codes to the invoice Maureen 980 dated 2 June The SAOPA / Nappi codes each one is correct !! It’s VERY CLEAR that most staff members don’t even know what a SAOPA/ Nappi code is As they think invoice needs to be of by pMB benefit NO!! It’s a exception ! Unusual request That’s wahy ruleexception payments dart had S process the invoice . Inside uooose collect my vital glasses tomo Friday Yet because of lack of insit and understanding , Nobody can get there act together . To actually make omt .

U have had enough of all these sent from Pilar to post . Only to have ZERO postive outcome . Althou the reviews.

****Very important ! ****Panel approved theses codes . *****’They would NOT have done it 10 June if they don’t excict . Pl s dint sendla auto reply we will investigate

- I’ll be doing that my self at 12 noon this morning I persone at SandtonHq . When insist to see the head manager as well cei office together .

- Maybe the head if depart . Ruleexceptionpayment can explain llto why his or her Dept is incompetence. -

The only time I will not arrive by 12 noon ymtiday . Is if I see a confirmation !! Not promise . Confirmation that the invoic 9cm8ch .

-Has been proceeded. The first person f…, it up . Because he did understand SAOPA codes R there every is completely messed up

Andries Kruger *** It’s been 8!days working days . No mt has be made by ruleexceptionpayment nor claimsadjustment Dept . Although both were informed via email regarding the error of the incorrect address being used first .

- Was re sent !!!!!!the same day by the practice and I have written several emails. Here are the ref number *** ******2 Last nite ref at8pm Re***3 Plus called the call centre so many times mnobidy seems have glue !! - What to do to get this paid correct m I will be coming in person at 12 am this notSandton HQ see Mr Adrian Gore office . - Maybe the someone can explain to him why incompetency bid taking place .

0
Replies (3)
Discovery Health
Discovery Health's reply23 Jun 2022, 10:34
Official
Dear Andries K

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

AK
Andries K's update23 Jun 2022, 15:34
Reviewer Update
This might sounds rude - honestly start by investaging the incompetency !! Iof your staff. Whi can t even understand what a special application , the word “ special @ shoukd re indicate . That it is not a normal day auto Omar ic grant f guve . With discovery you a panel that can make a dedsion wether the circumstances of the application will be in best cost effective interest idmf Discivery . Or if ur has abmny grounds for a real consultation . With paperwork , evedence provide with application and doctors motivation stating in their progressional iotionand experience what ever they final opinion might be I. The best interest of the patient z. When ch indirectly I’m the client and f Disvovery .
In my case the review boanel ask for soefic SAOPA : napppil codes Hich is nothing likeIDC10 codes . Aooorently f due t my eye unsussfull lense inplant 26 Jan. Result we’re hardly any vision. Infact it was actually confirmed on Saturday by Professor Ferreiras an aOptominyrist which backs up the finding of only 16./. Curren vision in the right eye .
That being . It’s main readmsin Dr Kara Sandri who wrote the motivational letter . Ehich form part to the approve letter that ccalked a decision letted . Dated 29”10 June - valid till 8 July
That letter has diffrent section each approving 100 per cent the cost stated on quotation 980 !! And the invoice dated 11 June. ***. !!
As per the SAOPA codes which the careful first confirmed before the decision e eas granted for R 11923’ 00.
100 percent Thr full amount state .
I’m the decision letter the SAMA. SAOPA codes were printed . On page 2 they clearly state that invoice must be sent to ruleexceptionpayment &fiscovery.go.za. With in 3 working days . The Will oay . Well from Monday 23 hJune . Around 20 am . They received in invoice from
***

uSe ‘. The mail address itself to find the original mail that was sent to that the department ! Yry it’s being dismissed ignore and b****+. Story give . There actual nothing wrong with any of the SAOPA codes . Because when letter was generate to capture’ !!! codes plus cost for each . It would of been flagged and not printed . Not only did review panel find them correct and your systems with i. Discovery medical .
Btym line is. Staff di t k ow what SAOPA is and what actual fall u det s” special otter exceptional “ application .
Obviously it won’t form part of normal PMB daily Benefits .

That’s why I had to do a special ( addition) above the normal cover a person would hav .

Plus they lcl welt state on page to that invoice and cods must sent to
Rule expectionpaymeny@ discovery.co,Comtherefor. I take that is f to he depart specially to pay invoice which of simussful. Being from them to the supplier

Pls to make easy contact
Mr Sibonelo.ngidi@ discovery.co.ss

As Mr Ngidi went far beyond the normal call of duty to ensure that this was made possible .’he has all the emails and fact to this matter

I’m actual speechless to hoe I can s be so so so difficult to add 2 +2=4
I'm sarcastic now
. The pint I'm trying proof of go and pull the quation number 980 R 22933.00
plus I'm voice *** Monday the 13 June
Then the decision letter date Approved
10 June
and Bob is your uncle.... Put in your hand walk over to reulexp...,, f depart hsnfmd over the the manager ( seeing agents don't under what they receive z... Appears to be Greek or a foreign laugh SAOPA / Nappi codes. Hopefully the manager will give additional training to his team to avoid such embarrassment which Been created I regards to harming the Discovery brand. I m due collect my specticsls tomorrow Friday y from the Optomitrist. Which vital for my daily vision. Just be able to do and see basic things.
Like where place ones foot Or not to e walki into a door. Or Wall etc. They will not release them with out pmt t. Which today is 9 r th working!! Say. Still struggling to t b e basic.
Of the right depart to act. No you tell me in honesty do you think when Mr Gore created the vision of a new medical aid many urs ago m that this was type oterible device he would aloud to be given to the public

No. No

should t honk I'm incorrect pls go ahead can contact his office directly
MrGore office repressive Mrs Kammy Iyer and myself had already since end Feb been in touch indirectly to this. Which directly us is fully aware of my codition anf other seriose offenses that a cured prevoisr medically. That's the reason she was allocated to overseas my needs. I'm extremely tempted to provide every single reference number. Time., date , names if this nightmare which started originally 13 May to day at least 21 reference number as of last lady might . Heads o departs , Mananger and staff can gladly indicate why a very important cases is so miss treated ‘. I can assure it wo t end well for all mentioned above my the office of the CEO




Junev2””””””” kine Doctor scans , medical reports
Discovery Health
Discovery Health's reply27 Jun 2022, 16:52
Official
Dear Andries K
 
We have been in touch with you to answer your comments.
 
Regards
Discovery Health Servicing Team