NON-PAYMENT OF PRESCRIBED MINIMUM BENEFIT CLAIM

I was operated on to correct a PUJ obstruction on 18/08/2014. I app**** for out-of-hospital treatment under Discovery's Prescribed Minimum Benefit (PMB) in 2014 (approved 14/09/2014). I consulted my urologist a year after the operation, so I renewed my PMB application in 2015 (approved 16/04/2015). This included: 'Diagnosis code: N13.0; Requested treatment code and description: 0190: New and established patient: Consultation/visit of new or established patient of an average duration and/or complexity; Quantity approved: 2; Explanation: Approved; Benefit from: 2015/02/24 to 9999/12/31'. I consulted my urologist on 24/02/2015 for follow-up. The treatment claim was rejected by Discovery Health, and I made payment to the supplier (R500.70) on 14/03/2016. I consulted again with my urologist on 11/08/2015, and this was paid by Discovery on 28/10/2015. I am contesting the first rejected claim for R500.70 for treatment on 24/02/2015. Discovery has rejected it multiple times on the basis of no medical savings. This clearly falls under PMB, not savings, as 1 of 2 approved consultations. It is unacceptable that the claim has been misinterpreted. I only receive automated responses to queries.