1 reviews | Active since Dec 2012
Non payment of claims
I was sent for blood tests on the 23/08/2014 to determine if I have a chronic illness. On the 29/08/2014 I was approved for chronic illness benefit. The approval letter states the treatment guidelines for the prescribed minimum benefit .1 of the benefits stated is that I will be covered for 1 diagnostic test, which did not get paid as yet. I queried the claim with discovery and was advised that the code used was incorrect and to get the pathologist to rectify, which they did and resubmitted. The claim has still not been paid. I called in today (18/05/2015) and the call centre agent is still saying that the ICD 10 code is incorrect. SO I called the pathologist again and they confirmed that they did change the code to the correct code when they resubmitted. I have made 5 calls today to discovery health and if my call is not dropped, the agent tells me that my claim wont be paid if the codes are not right. Im am getting torn between the pathologist and my medical aid now, and it seem that discovery is trying to find a loop hole to not pay this account. And why must I be the middle man here? The pathologist is now handing me over to recover the costs.
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Kind regards
Discovery Health Servicing
Thank you for your comment.
We are currently investigating your query and will contact you to provide feedback.
Kind regards
Discovery Health Servicing
