MB
Marinelze B

1 reviews | Active since Dec 2023

29 Dec 2023, 09:15

Incredibly frustrating administration regarding claims

I have been battling with discovery to pay a specialist since July. All the appropriate routes where taken, I have called and enquired several times, each time being ensured that all is resolved and that the claim will be payed out. Just to find out every time that it is still not paid for some reason.

We are pregnant with our fourth child, had a miscarriage just before this pregnancy. Now there is an administration issue with the previous pregnancy benefit basket causing scans and bloodtests that would otherwise be covered, to not be covered. I have also called and enquired about this, once again being ensured that it is now resolved. Just to find out it is still not resolved and claims are not paid and left to my account.

The administration is extremely frustrating. Getting through via call centre becomes an expense on its own trying to get everything resolved multiple times.

And with the income verification there has been a further administrative fault. I provided bank statements, payslip statements, everything as incredibly complete as it possibly can be. And now they have put me on a income bracket that I should not be, meaning I will pay double the payment that I should. Now once again trying to resolve their messes. I am so tired, frustrated and honestly angry.

I have been a loyal member of discovery for almost 10 years, very seldom having issues. But this year their system is a complete mess. I am strongly considering moving to a better equipped medical aid that actually cares about their members.

0
Replies (8)
Discovery Health
Discovery Health's reply29 Dec 2023, 10:20
Official
Dear Marinelze B

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
MB
Marinelze B's update03 Jan 2024, 07:24
Reviewer Update
I look forward to you getting back to me and will also update the post with your feedback
Discovery Health
Discovery Health's reply03 Jan 2024, 11:18
Official
Dear Marinelze B

We’ve sent feedback to you on email as we could not contact you telephonically. 
   Regards Discovery Health Servicing Team
MB
Marinelze B's update03 Jan 2024, 11:52
Reviewer Update
Thank you , I have responded to that email. I called discovery and was in a telephone conversation with a discovery consultant during that time regarding the income verification . Which was sorted out by a very sharp and helpfull Rayhan Sheik. I look forward to your reply on the email.
MB
Marinelze B's update09 Jan 2024, 12:20
Reviewer Update
Good day, I just want to follow up on the progress regarding our email communication?
MB
Marinelze B's update17 Jan 2024, 08:10
Reviewer Update
Good day, my previous comment a operator called me. It was a conversation. He said that it would take 2-3 working days to sort the claims. This is day 6.
MB
Marinelze B's update18 Jan 2024, 12:13
Reviewer Update
I have still not received any feedback regarding this. On 9 January a consultant called me, after a long , what seemed to be a successful conversation he said that the claims will take 2-3 working days to process. It has now been 7 working days and literally no emails or calls whatsoever. Just as I though there was hope and things are being processed, once again nothing happens on the administrative side. What is going on?? In the meantime I had to pay for the specialist that has not been covered in July 2023. I went to both consultations with separate authorization codes for each, the one was paid, the other one not. This was the first time my son saw a specialist that year and the specialist cover was far from depleted. Each time I enquired a different code was given for why this claim was not paid. Monday I am seeing my Gynecologist for our 18week visit and will be facing an outstanding claim that I have brough under Discovery's attention 6weeks ago. 6 weeks. This claim was not paid because of a persistent issue on their side to reset my maternity basket after I had a miscarriage in June 2023 (this was one again confirmed and assured to be sorted out in the 9 January call) Administration is an absolute mess to detangle. Beyond frustrated at this point, this service is something to be ashamed of.
MB
Marinelze B's update31 Jan 2024, 11:50
Reviewer Update
I have patiently waited hoping to receive feedback. It is now 31 January. Can someone please let me know what the status is regarding the maternity basket administration mishap? How long must I be kept on a line? Should I waste more money trying to get a hold of a consultant just to wait some more?? Just as I was beginning to think there is some so progress everything comes to a complete standstill.