MS
Mariska S

1 reviews | Active since May 2012

17 Jan 2022, 10:20

FULL CLAIM REJECTION

I am on the key care plus plan and I do realize that we are very limited with certain medical procedures and visits to health care professionals. However I have been to the dentist for a check up and nothing was paid for me the entire claim was declined and it is a dentist that works with keycare.

I olny came to know about this when I took my children to the same dentist a week later and got a statement from them.

I just feel that should you not cover or want to cover any dental treatments why even have it as an added benefit to the medical plan. I honestly cannot afford to pay an acc of R 2162.10 because nothing is being covered.

My Claim Statement reads as follow : 04/01/2022 STRYDOM MA MRS 00 1991/08/29 COHEN B DR *** DP***4 x 1.00 LIMITED ORAL EXAMINATION ICD-10 K01.1, K12.2 Rejection Reason : Plan does not cover this treatment / test 8109 x 2 INFECTION CONTROL / BARRIER TECHNIQUES ICD-10-Z01.2 EDI : REJECTED BY SCHEME 8110 X 1 STERILIZED INSTRUMENTATION ICD-10 Z01.2 EDI : REJECTED BY SCHEME 8115 X 1 EXTRAORAL RADIOGRAPH - PANORAMIC ICD-10 X01.2 Rejection reason : Plan does not cover this treatment / test

and the list goes on WHY DO I HAVE DENTALO BENNEFITS IF NOTHING IS COVERED WHAT DENTIST DO WE USE I MEAN THIS IS SOMETHING ONE DOES ONCE A YEAR AND NOT EVEN BEING COVERED FOR ANYMORE.

0
Replies (3)
Discovery Health
Discovery Health's reply17 Jan 2022, 10:26
Official
Dear Mariska S 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
Discovery Health's reply17 Jan 2022, 13:09
Official
Dear Mariska S We have been in contact with you to discuss your concerns.  Regards Discovery Health Servicing Team
MS
Mariska S's update17 Jan 2022, 13:14
Reviewer Update
Thank you