tM
tryphina M

1 reviews | Active since Jan 2014

15 Feb 2018, 09:48

pathetic fustrating service ever

am still awaiting feedback from discovery regarding my complain why the claim by my gynaecologist was rejected, because their excuse just frustrates me to say claim denied because I did not receive referral or authorisation from them to visit this doctor even though I do not need a referral to visit him for maternity care its on page 21 of key care series health plan guide 2018 quoted below Specialist Benefit All plans have specialist cover-up to R3 860 per person per year. Your GP must refer you to a specialist and you need a reference number from us before your consultation with the specialist. If you need to see a maxillo-facial surgeon, periodontist, ophthalmologist or a specialist for maternity care, you do not need a referral from your GP or a reference number from us. The KeyCare Access Plan covers specialist visits in our network for maternity, care for your baby up to 12 months after the baby is born, and trauma and emergencies up to the limit. For all other healthcare services we cover specialists employed by a state facility. Visit.These healthcare services for maternity and early childhood are covered from the Maternity Benefit at the Discovery Health Rate. This cover does not affect your day-to-day benefits and depends on the plan you choose. Benefits will be activated when your pregnancy profile is created in the Discovery app,on our website www.discovery.co.za, when you preauthorise your delivery or when you register your baby onto the Scheme. These benefits are available from 2018 per pregnancy per child up to two years after birth. I have already preauthorise my baby delivery. Its frustrating cos I still need to visit this doctor but right now I cant because discovery doesn't want to pay him.

0
Replies (4)
Discovery Health
Discovery Health's reply15 Feb 2018, 11:00
Official

Dear wisane667

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 reply15 Feb 2018, 14:45
Official

Dear wisane667

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

Regards
Discovery Health Servicing Team

tM
tryphina M's update15 Feb 2018, 14:48
Reviewer Update
I will only be satisfied when the issue has been resolved
tM
tryphina M's update22 Feb 2018, 10:53
Reviewer Update
6 days ago I was promised that my rejected claim would be fixed because they had a problem with their maternity claims systems, however I think they are playing us for fools and putting our health in jeopardy and seems am not the only one having the same issue with them despite the fact that discovery is taking forever to approve my chronic medication which am paying a fortune whilst waiting for them I also have to pay for a gynaecologist cash but I have a medical aid which am paying every month what kind of service is this am pregnant, stressed and frustrated at the service that am getting from them its so pathetic that they promise to fix the issue within 48 hours but they know they are just playing with my life and the life of my unborn baby I have to miss my appointment because am waiting for discovery to pay him cos he wont continue to treat me whilst he's receiving nothing am tired of this this is my third complain and no one is doing anything about it what is this