CB
Christina B

1 reviews | Active since Jan 2013

21 Jul 2016, 07:47

PMB claim

<p>I registered for a Prescribed Minimum Benefit for my daughters Occupational Therapy. When I submitted the claim it was paid out of our Medical Savings Account instead of the PMB. Only after the third enquiry the phone consultants told me that it was because the ICD10 code on the OT's statement was wrong. She used the treatment code and not the diagnosis code.</p> <p>I then asked the OT to correct this and resubmitted the claim for the adjustment between the MSA and PMB. I had to phone twice again for someone to be able to assist me. She sent it through to the adjustments department.<br />I have phone now again 3 times to follow up on the adjustment. The consultant that sent it through to adjustments is suppose to phone me back, but it's been a week since she sent it through and I'm still waiting for a reply.</p> <p>When I phoned 2 days ago the consultant said she could see they reprosessed, but can see they still didn't correct it between the MSA and PMB. She didn't want to open a newe query cause that would duplicate things.</p> <p>I phoned again this morning to try and resolve the issue. But the first call....I got cut off halfway through the options selections. Second try...someone "answered" the call....I could hear the consultants in the backround, but there was no one to speak to me.</p> <p>Every time we apply for PMB we have to go through this "shlep" to get our benefit. This is unacceptable!!</p> <p>Reference for the query is ********** 821. Please can someone capable assist us in this query.</p>

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Replies (2)
Discovery Health
Discovery Health's reply21 Jul 2016, 08:39
Official

Hi Christelle Blom

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 reply27 Jul 2016, 08:38
Official

Hi Christelle Blom

We have contacted you with a resolution to your issues. Please be in touch if you have any other concerns.

Regards
Anil