Please see below quoted review:
"28 Feb 2024 at 10:18
Misinformed on chronic benefits and making up excuses not to pay
I have spoken to a few operators, especially in the chronic department. I would like to formally complain about Discovery not paying Capitol Radiology for a swallow test done on 09/02/2024: I sent an online query to Discovery explaining that last year my nominated GP send in the application form to go see rheumatologist, Dr. Joyce Ziki. It was declined and I pay her cash since last year; September 2022. She did the right tests and app**** for the chronic condition: arthritis and uses a ICD-10 code of M06.99 on any test requested. The problem is I did the swallow test on 09/02/2024 and on the physical form the chronic ICD-10 code, M06.99 was written down after I paid cash to see Dr. Joyce Ziki. The claim was not paid due to Capitol Radiology using a chronic ICD-10 code R 13 out of own judgement. I called Discovery and a operator at the chronic department instructed me to request Capitol Radiology to change the chronic ICD-10 code to M06.90 on the 15th of February 2024. She was well aware and told Dr. Joyce Ziki wrote the chronic ICD-10 code M06.99 on the physical paper requesting the test. Capitol Radiology sent the claim through again with the given ICD-10 code; M06.90. The claim was not paid again due to the following reason: "338: We have not paid this amount because this claim because you have not followed the specialist referral process on you. Please pay this amount to your specialist." I talked to two operators today, 28/02/2024, and especially to Bongolethu in the chronic department. She explained to me on the chat platform that the code should have been M06.99 and not M06.99. She said that the chronic benefits for arthritis does not cover the swallow test. My question is how does no one give me this information since enquiring online (Website query) ; calling the chronic department on the 15th of February 2024 and now talking to the operators through the chat bot application. I do not see the justification in paying Capitol Radiology under the reference due to reason 338. I did not see a specialist. My rheumatologist, treating me for arthritis, requested the quest using the ICD-10 code M06.99 to further her treatment. I suggest give me the real reason for not paying Capitol Radiology for the swallow test with the given ICD-10 code M06.99 OR I will be looking for a new medical aid immediately!"