IN HOSPITA DRS CLAIM SETTLED INCORRECTLY

Claim for Dr "N", service date, 12 April 2024 was not settled correctly as per the reason codes. In my conversation with the agent, regarding the R716.82 and R1 260.77 it clearly states, RC, 850, which states the service provider was paid an additional amount, yet it was reversed as per the agent and drs rooms. Discovery Health call (08/05/2024) (Call ***). These amounts are not payable by the member (not responsible for this portion or claim it from the member) and should be paid by Discovery as per the payment arrangement they have with the dr as the procedure was done in a day clinic, and I am also on the Classic plan.

I need someone to please contact me in order to resolve this matter asap.

Thank you.