SS
Suzanne S

1 reviews | Active since May 2021

04 May 2021, 20:53

No reasons for declining PMB claim

I have been struggling for more that 6 weeks for Discovery to pay for a PMB ( Prescribed minimum benefit). They just keep responding with “ Your request was declined” and then they are so unhelpful to list why. A wonderfully clear “ We need the following • Diagnosis of prescribed minimum benefit. “ And that according to them should explain why they declined multiple reports diagnosing me with a PMB . Even the theatre report noting the removal and thus confirmation of the diagnosis is not enough for them. And here is the important part. No one can give me a reason why.

0
Replies (3)
Discovery Health
Discovery Health's reply05 May 2021, 07:38
Official
Dear Suzanne S 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 reply05 May 2021, 15:12
Official
Dear Suzanne S 

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

Regards
Discovery Health Servicing Team

SS
Suzanne S's update05 May 2021, 18:02
Reviewer Update
By saying it is because we do not agree that you have a PMB, but we can not tell you why. Then saying o no, oops, it is because you have a PMB but the treatment was not in line with the treatment for the PMB. And no we can not tell you why we do not think that your surgical management doesn’t count as surgical management.