1 reviews | Active since Nov 2012
PAY BACK THE MONEY!
I have submitted a claim to Discovery on the 20/01/2015 (ref ***) and got a reply on the 27/01/2015 that it cant be settled as the procedure number is unreadable, but it didn't make sense to me because I could see it quite clearly. I then resubmitted the claim on the 29/01/2015 (ref ***) and made the invoice clearer and highlighting the procedure code. To date I have had no response on that claim. Meanwhile I found out, after many up and down phone calls, that this procedure code on the invoice was actually an ICD10 code (still don't understand what it means). I then went and got a new invoice with the correct procedure code and submitted the claim for the third time (ref ***) on the 09/02/2015. The service from the claims department has been pathetic to say the least. I was told that the turnaround time for settling this claim would be 2 to 3 days. All in all I have been waiting 4 weeks to have this money refunded. Please sort yourselves out and PAY BACK THE MONEY!
Thank you for your comment.
I investigated your query and confirmed that claims submitted to the Scheme do require certain information to be processed. The following information must reflect on the claim:
o Your membership number
o Patient's name
o Healthcare provider's name
o Healthcare provider's practice number
o Account number
o Treatment date
o Tariff/Procedure/NAPPI codes
o Amount claimed
o Diagnostic code (ICD-10 code per line billed).
As discussed we rely on the providers to all the relevant information on claims and I do trust you have a better understanding of how we process claims. I confirmed telephonically the payment details of the claim.
Thank you for allowing me to assist with your query.
Kind regards
Jashvir
Thank you for your comment.
I investigated your query and confirmed that claims submitted to the Scheme do require certain information to be processed. The following information must reflect on the claim:
o Your membership number
o Patient's name
o Healthcare provider's name
o Healthcare provider's practice number
o Account number
o Treatment date
o Tariff/Procedure/NAPPI codes
o Amount claimed
o Diagnostic code (ICD-10 code per line billed).
As discussed we rely on the providers to all the relevant information on claims and I do trust you have a better understanding of how we process claims. I confirmed telephonically the payment details of the claim.
Thank you for allowing me to assist with your query.
Kind regards
Jashvir