MB
Mark B

1 reviews | Active since Mar 2009

05 Apr 2016, 14:58

Non Paymeny of Radiology Claim

Late last month I went for a follow up appointment with my doctor for an abscess I had on my left lung diagnosed last year September. In September last year , as part of the diagnosis I had x-rays done of chest to determine whether I had an abscess on my lungs. I did and was treated for this accordingly. Discovery covered the cost of the x-rays as it was not a preexisting condition. <br> <br> I went again at the end of March for a follow up appointment and again had another set of x-rays done to determine if the abscess had cleared up properly. Discovery has rejected the claim stating that it is because it forms part of a preexisting condition. This is not factual at all as last year September was the first time that I was diagnosed with this condition ever in my life. <br> <br> I spoke to a call centre agent last week who re-submitted the claim only to have it rejected yet again by the claims department stating that it is not covered as it is a preexisting condition. <br> <br> It would appear that the claims department representative who is dealing with my claim is not assessing my claim correctly.

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Replies (1)
Discovery Health
Discovery Health's reply07 Apr 2016, 12:09
Official
Hello markieb,

Thank you for your comment.

We have confirmed that you have been contacted and your query addressed. The claim was rejected as the diagnosis code your healthcare provider submitted on the statement confirmed treatment of a condition for which you are not currently covered. In order for us to review this claim, kindly submit the requested documentation at your earliest convenience.

Regards
Norman