1 reviews | Active since Sept 2013
No feedback or Callback from Discovery
What a nightmare dealing with Discovery. I had maternity blood tests done on 06 Oct 2021. the claim was sent to Discovery on 09 Oct 2021. I was then advised by the service provider that the account was partially paid on 03 Nov 2021. The consultant advised the ICD10 codes that were noted on the invoice was incorrect and needed to be loaded correctly. The consultant confirmed on the call that some of the tests that were on the invoice will be covered under my maternity benefit if the ICD10 codes are corrected. The new invoice was submitted to Discovery with the same results. I was made aware once i received another sms to pay the account from the service provider. I called Discovery again on 30 November 2021. the consultant advised that the ICD10 code is still incorrect and the way it was amended was incorrect and he then tried calling the service provider who advised that the invoice cannot be amended on each line. The consultant advised he will refer this to a back office that will manually change the claim and resubmit the claim again. I was given a turnover time of 2 – 3 working days and told I will receive an email or call back. On 08 December 2021 i called again as there was still no feedback. I was advised they can't see what is happening with the claim as it went into a batch and they will ask someone to call me back. Apparently a call back was done on 10 Dec 2021 however I have no missed call, no email or sms but lets give the benefit of the doubt and say its a problem on my end.... I called again on 17 December 2021. The same feedback was given, they cannot see any details and will need to ask the consultant dealing with the batch. The consultant confirmed that he will call me with feedback. I also asked the consultant to confirm if I pay the account, will Discovery reimburse me whatever the amount is that they pay. I was told he is not sure and would advise me not to pay the account until I have feedback from them as Discovery may just pay the service provider as well. Again, no feedback and I called on 21 December 2021. I was told the same story again, they cannot confirm where it is and will ask a consultant to call me or ask a consultant for feedback. Again, i asked if I pay the account, will Discovery reimburse me if the claim is paid. I was told again they are not sure and it will be a gamble that I will need to take. At this point after nearly 2 months of struggling with the claim, I wrote a complaint on Hello Peter. On 22 December 2021, I receive a call from a complaints consultant who is calling back relating to the complaint of no call backs. I was immediately told by Sesha that the claim cannot be paid with a reason which I then questioned. I gave reasons and motivated why i felt this is unfair. I then advised the consultant that I was told by the consultants that the bloods would be covered by some consultants and asked why I was told for 2 months to wait for the claim, she could not answer and said she is unsure why other consultants did not check properly and she looked further into the claim where they possibly did not. I wanted the claim to be reviewed based on what I explained. No feedback again. Now during this month its a new problem. I was transferred to a Manager yesterday (12 Jan 2021) relating to the new problem and I advised her that I would like the new matter resolved and I would like the claim to be looked into and reviewed as I have had no feedback. She resolved my new query as best she could and I was assured that she will get the correct department to give me either yesterday or by close of business today. I checked the call, it took place at 14:30 so lets say it ended at 15:30. I called Discovery AGAIN at 14:44 as AGAIN I did not receive any calls.... I was told that they will get either the manager I spoke to yesterday or the person the query was escalated to to call me back. I was advised the escalation was only done this morning at 08:51, which is another unnecessary delay on Discovery's side. I asked the consultant to get the complaints, manager or manager I spoke to to call me back by 16:30..... not a single call. i registered a complaint and she couldn't find a complaint with the reference number i had. The consultant then transferred me to another department who is trying to assist and investigate. This is pathetic service from Discovery. It is extremely unfair that I was made to believe from 03 November 2021 that the account will be paid from my maternity benefit if the invoice is correct. I was lead to believe it will be if the invoice was corrected and I did the running around to get this resolved, I was not told the maternity benefit must be activated immediately, I was advised by Discovery not to pay the account until their claim is finalized and the lack of service as well as the delays by Discovery has been unnecessary and extremely stressful. This is now not only causing stress relating to this specific incident but going forward in my entire pregnancy as I will need to be concerned for the rest of my pregnancy.
