TC
Tryphina C
1 reviews | Active since Jul 2011
09 Nov 2015, 16:40
NO HELP FROM DISCOVERY
Sent a mail to Discovery Claims advising that my Primary Dr who's listed on the Key Care Plus Network wasn't available as he is currently on Sick leave, had to be attended by another Dr and paid for the consultation. Now trying to claim the fee from Discovery health, not even the full fee as i requested to be refunded what they would have paid my Dr. Barry Haricombe responds and tells me they're sorry my Dr wasn't available, they cannot assist. Don't i qualify for Out of Network Dr consultation per year? Why can't i be refunded what is due to me??????
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Discovery Health's replyOfficial
24 Nov 2015, 15:23Hello Phos,
Thank you for your query regarding the Primary GP not being available. Our details reflect that your out-of-network benefit was already used on 01 July 2015 where we reimbursed the full amount to the relevant healthcare provider.
Unfortunately due to your one out-of-network visit for 2015 already being utilised, we would not be able to reimburse you for your claim. We can confirm that you have both your primary and secondary GP options selected and in instances like these your secondary GP option would need to be considered to ensure your claims get funded accordingly. We have also reviewed the correspondence Mr Haricombe sent to you on 05 November 2015 and can confirm that he sent you details of both your Primary and Secondary doctors for consideration at the time.
Please note you are entitled to change your nominated doctor three times a year, however, these changes are effective from the 1st of the following month.
Regards
Tracy Thomas
Thank you for your query regarding the Primary GP not being available. Our details reflect that your out-of-network benefit was already used on 01 July 2015 where we reimbursed the full amount to the relevant healthcare provider.
Unfortunately due to your one out-of-network visit for 2015 already being utilised, we would not be able to reimburse you for your claim. We can confirm that you have both your primary and secondary GP options selected and in instances like these your secondary GP option would need to be considered to ensure your claims get funded accordingly. We have also reviewed the correspondence Mr Haricombe sent to you on 05 November 2015 and can confirm that he sent you details of both your Primary and Secondary doctors for consideration at the time.
Please note you are entitled to change your nominated doctor three times a year, however, these changes are effective from the 1st of the following month.
Regards
Tracy Thomas
Discovery Health's reply24 Nov 2015, 15:23
Official
Hello Phos,
Thank you for your query regarding the Primary GP not being available. Our details reflect that your out-of-network benefit was already used on 01 July 2015 where we reimbursed the full amount to the relevant healthcare provider.
Unfortunately due to your one out-of-network visit for 2015 already being utilised, we would not be able to reimburse you for your claim. We can confirm that you have both your primary and secondary GP options selected and in instances like these your secondary GP option would need to be considered to ensure your claims get funded accordingly. We have also reviewed the correspondence Mr Haricombe sent to you on 05 November 2015 and can confirm that he sent you details of both your Primary and Secondary doctors for consideration at the time.
Please note you are entitled to change your nominated doctor three times a year, however, these changes are effective from the 1st of the following month.
Regards
Tracy Thomas
Thank you for your query regarding the Primary GP not being available. Our details reflect that your out-of-network benefit was already used on 01 July 2015 where we reimbursed the full amount to the relevant healthcare provider.
Unfortunately due to your one out-of-network visit for 2015 already being utilised, we would not be able to reimburse you for your claim. We can confirm that you have both your primary and secondary GP options selected and in instances like these your secondary GP option would need to be considered to ensure your claims get funded accordingly. We have also reviewed the correspondence Mr Haricombe sent to you on 05 November 2015 and can confirm that he sent you details of both your Primary and Secondary doctors for consideration at the time.
Please note you are entitled to change your nominated doctor three times a year, however, these changes are effective from the 1st of the following month.
Regards
Tracy Thomas