1 reviews | Active since May 2015
Homeopathic Claim pending payment since Sep & Oct
I find it bazaar that in South Africa we pay a huge amount monthly toward medical aid, being on Discoveries Classic Comprehensive scheme has its benefits so not all is lost. However recently we have been experiencing a problem with two claims. The call centre staff tell us the ICD10 code is incorrect and needs to match the nappi code. My understanding is that the ICD10 code is the Diagnostic code and the Nappi code the Medicine code, why would they be the same as the call centre keeps telling us. These two claims are now outstanding for months, but yet Discovery has made no effort in contacting the Homeopath or at best even given us prompt feedback. It seems that irregular claims are dumped into file 13 and if everyone keeps quiet he patient will go away. The disturbing fact is the claims in May and Aug from the same homeopath using the same ICD10 codes was paid to us by Discovery and call centre response to that: They have no idea why those where paid but the latest claims not. Maybe as a suggestion the call centre staff should be trained in IDC10 and Nappi codes and think out the box by phoning the Doctor and not just reject without notification and file 13.
Thank you for your comment.
We sincerely apologise for the manner in which your claims were handled. As discussed, your claims have since been reprocessed and will be refunded to you.
Regards
Arthi
Thank you for your comment.
We sincerely apologise for the manner in which your claims were handled. As discussed, your claims have since been reprocessed and will be refunded to you.
Regards
Arthi
