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MJ
Melody J

1 reviews | Active since Aug 2014

12 May 2021, 09:59

Health Claim delayed because of payment error from Discovery

I had to pay R46000 upfront to medical specialist in April. My Classic Saver plan only covered a portion of this, which I understand, but my claim is still not sorted out. Discovery made a mistake and did not read the Doctor's statement properly - they had the amount claimed for as R37000 instead of R4600 and now I am being short paid. I spoke to Amore this morning, she was very helpful and kind- however I am still not happy that my claim was processed in error! Such mistakes should not be allowed at a company like Discovery- How long will I now have to wait for this claim to be settled as I still haven't received a cent and I have paid the specialist in full 1+ month ago. Reference: Membership number: *** -MailRef#*** and #***

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Replies (3)
Discovery Health
Discovery Health's reply12 May 2021, 11:19
Official
Dear Melody
 
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
MJ
Melody J's update13 May 2021, 16:02
Reviewer Update
Good day Discovery - I have just logged into my Discovery App online - and I see that there were adjustments being made - only problem is there is no adjustment as the R10,000 that was showed as R1000 claimed, now shows "Adjusted - with EXACTLY the same amount (R1000 claimed!!!) THE CORRECT AMOUNT for ICD-10 J34.2 is R10,000 AND NOT R1,000!!!!!! Can your claims processors not read that there are 4 x zero's? So here we go again! How long is it going to take to process and PAY my claim!????
MJ
Melody J's update13 May 2021, 16:04
Reviewer Update
....AND then to top it all off, I phone Discovery and hold on for almost 10 minutes and then I get transferred to an operator who just mutes the call completely without even greeting! So I eventually put down the call.