NN
Nokubonga N

1 reviews | Active since Apr 2013

06 Sept 2018, 12:14

Maternity claim not processed the same as others around the same period

I am unsatisfied with the manner in which the claim from Dr V Nandlal dated 27 February 2018 was processed by Discovery (in mail reference number ********** 811). This was in fact a resubmission.

I had joined the maternity programme as soon as I could in January 2018. The reason I remain unhappy with your claims amount is that the claims surrounding that one in February were processed to only have R301.30 unprocessed. Amongst those are the claims dated 23 January 2018, 13 February 2018 and 21 March 2018. During that time, I was still covered under the Coastal Core plan.I changed to Keycare Plus a couple of months ago. Furthermore, I did not use all the 8 obstetrician visits that were available on the maternity benefit. Sadly, my estimated date of delivery was 22 March 2018 but I ended up not using Dr Nandlal and delivered my baby on 5 April 2018. This claim was processed after my prenatal benefits were valid. What has suddenly changed that makes this claim different to the 3 I have referred to in this email? Kindly study the attached statement and see if there has not been an error made on your side in the way the 27th February 2018 claim is being handled by your office. Please urgently attend to this matter as I might face legal action by the end of this week. Why is this claim processed differently to the others in the same period?

0
Replies (2)
Discovery Health
Discovery Health's reply06 Sept 2018, 12:41
Official

Dear nokzae01

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 reply10 Sept 2018, 12:25
Official

Dear nokzae01

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team