1 reviews | Active since Jul 2015
No feedback / communication with customer
I am appalled with the lack of communication as well as the customer service I have experienced with Discovery Health. I submitted a medical claim on 30/03/15. The doctor's visit took place on 31/01/15 hence, my submission was within the allowed 4 month period. However, the practice number on the doctors invoice was incorrect. Whilst trying to get the correct information, I was told that I need not worry as my claim was submitted on time and I will still be paid once the information has been corrected. This was rectified and resubmitted to the claims adjustments department on 15/05/15. I have made numerous calls to get feedback. Eventually, on 21/07/15, I was told that my claim was not submitted on time therefore R0 will be paid. I was told I would be contacted within 48 hours. I did not receive a call hence, I called once more. I was then told that I was not contacted due to an inquiry which was in progress and that the operator who I dealt with (on 21 July 2015) will contact me. To date I haven't received any contact from anybody within the organisation. I cannot fathom why it is so difficult to keep a customer informed as well as why I was told that my claim was submitted late!
Thank you for your comment.
I investigated your query and confirmed when claims are submitted to the Scheme we require certain information to reflect on the claim. The claim must include amongst other information a valid ICD-10 (diagnostic code) on each claim line. We have contacted the provider to confirm this information. We are awaiting the amended claim to assist with your query further.
We do allow members and provider up to 4 months from the date of service in which to submit claims. After this period claims are considered late and cannot be processed. After investigating your query we will process the claim as the original claim was submit to us in time and we have record of this. I do sincerely apologise for the manner in which your query was handled. I am addressing this internally to ensure this does not occur going forward.
Thank you for allowing me to assist with your query.
Regards
Jashvir
Thank you for your comment.
I investigated your query and confirmed when claims are submitted to the Scheme we require certain information to reflect on the claim. The claim must include amongst other information a valid ICD-10 (diagnostic code) on each claim line. We have contacted the provider to confirm this information. We are awaiting the amended claim to assist with your query further.
We do allow members and provider up to 4 months from the date of service in which to submit claims. After this period claims are considered late and cannot be processed. After investigating your query we will process the claim as the original claim was submit to us in time and we have record of this. I do sincerely apologise for the manner in which your query was handled. I am addressing this internally to ensure this does not occur going forward.
Thank you for allowing me to assist with your query.
Regards
Jashvir
