SN
Stacey N

1 reviews | Active since Oct 2015

18 Feb 2021, 17:08

Liable for a benefit which Discovery did not cover

Can Discovery Health stop wasting my time. 3 queries was logged with regards to my dental benefit being depleted even though no monies was paid to the dentist!! I have queried this multiple times. After constantly following up and wasting airtime, they get back to me with the answer that 'Please note that your limit was used correctly as member is liable for a co-payment of R165.00 for the procedure code 8109'. What kind of answer is that?? How can I be liable for a co payment but ZERO was paid to the dentist. ZERO!! it even shows ZERO on your app and website. So please tell me why my benefit is depleted and I am liable for a co payment when Discovery paid ZERO to the dentist. So you telling me that I have to pay money for something that discovery didn't even cover?? Is this how your benefits work?! After 3 weeks I get am answer like this that doesn't even make sense. 3 weeks just to give me such answer that holds me liable for a claim?? Is this how you treat your clients?? How much more of my time is discovery going to waste with this. Please answer me why am I liable if nothing was paid out of this benefit

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Replies (4)
Discovery Health
Discovery Health's reply19 Feb 2021, 09:03
Official
Dear Stacey
 
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
Discovery Health
Discovery Health's reply23 Feb 2021, 09:18
Official
Dear Stacey
 
We’ve responded to your query.
   
Regards 
Discovery Health Servicing Team
SN
Stacey N's update23 Feb 2021, 11:55
Reviewer Update
Sending me PDFs does not resolve my issue!! I know how my benefit works. I will even copy and paste from your PDF!!!

'One defined dental check-up per year with an upfront payment of:
R110 on Classic
R165 on Essential
The balance will be covered up to the Discovery Health Rate (DHR)'

As stated above, R165 is the Co payment and the balance will be covered by discovery. But if you go to my claim on my profile, ZERO balance was covered by discovery. So why is the Co payment required??? Do you not get this?! I'm tired of going back and forth and not getting a proper answer
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Stacey N's update23 Feb 2021, 12:30
Reviewer Update
I just called your call centre! Lady was very rude and put me on hold for a very long time after the discussion. Waste of airtime. Issue still not resolved. How can transactions happen on my profile but I have no view of it.