********** claims and false information from Discovery Health agent

Hi

I would like to report a ********** claim. On 28 August 2019 I visited Dr I M S Rawat who is part of the Discovery Essential Smart network GP's as per the document I received from Discovery. My Discovery Essential Smart medical aid says that if I visit any network GP I have to pay R100 upfront and then Discovery will settle the rest. Upon my visit to Dr Rawat I paid the R100 upfront prior to consultation as requested. I then had my consultation with the doctor and that was it. A few weeks later I received a claim notification from Discovery for my GP visit at Dr Rawat however after I called Discovery and spoke with Thapelo who confirmed that Dr Rawat took the claim ammount as 1 of my 8 Antenatal maternity visits which was not the case. I visited Dr Rawat as a normal GP visit hence paying R100 upftont.

To make matters worse I spoke with Thapelo at Discovery on Friday 27 September 2019 who on the recorded call confirmed with me that he will contact Dr Rawat to sort out the matter. Thapelo also confirmed on the recorded call with me after I asked "Is there anything else that needs to be done from my side?" , he said "No" on more than one occassion.

I am therefore mailing you before having to resort to Twitter and HelloPeter in the hopes that you can resolve this matter because I am lodging this complaint regarding the ********** claim from Dr Rawat as well as incorrect information being provided to me by the Discovery call contact center representative Thapelo who was supposed to also call me back later the day and did not do so.

Pleaee respond to me via mail soonest.

Regards R Ebrahim