1 reviews | Active since May 2018
POOR POOR SERVICE DISCOVERY!!!!!!!!!!!!!!!!!!!!!!!!!!!!
I JUST HAD IT WITH DISCOVERY!!!!!!! SEE BELOW POST ON 17 SEPTEMBER 2021, I WAS PHNED BY A GENTLEMAN "WHO PROMISED TO SORT THIS OUT". THE SURGEON CONTACTED ME AND GAVE ME NEW CODES. I PHONED YESTERDAY AT 17H00, SPOKE TO "PHERSIA" WHO WAS FRIENDLY AND DID THE WHOLE AUTHORISATION WITH ME, ASSURED ME THAT ALL THREE PROCEDURES WILL BE PAID AS PER SCHEME RATED. THIS MORNING I CONTACTED THE GINACOLIGIST AND SURGEON, GAVE THEM THE AUTH NO, AND BOOKED MY SICK LEAVE. I WAS RELIEVED THAT MY FAITH WAS RESTORED IN THE SCHEME AGAIN. NOOOOOOO!! THIS AFTERNOON I GOT A EMAIL TO INFORM ME THAT THE AUTH WAS PUT ON HOLD, I GT A PHONE CALL FROM PHERSIA, JUST TO TELL ME THAT SHE WAS AT FAULT AND SHOULD HAVE ASKED FOR MORE INFO. HELLLOOOOOOO???? DISCOVERY WILL LIFT THE HOLD FOR THIS AUTH AND IT WILL BE PAID. I WILL KEEP DISCOVERY ACCOUNTABLE FOR THIS AUTH AND ALL CLAIMS WILL BE PAID. HOW CAN YOU CONFIRM, JUST TO PUT A HOLD ON IT THE NEXT DAY????????? PLEASE, PLEASE GET YOUR HOUSE IN ORDER!!!!!!!!!!! I EXPECT THIS TO BE SORTED OUT TOMMORROW 22 SEPTEMBER!!!!!!!!! POST FROM 17 SEPT: VERY dissapointed Discovery client! I am very very disappointed in Discovery not wanting to pay for my procedure. We’ve been on Discovery for 20+ years and never experience this kind of service before. Always referred to your good service and recommended people. We were NEVER high claimers. (I will definately not recommend the Scheme anymore.)We've paid thousands of rands over the years, and you simply refuse to pay for this.
I wil be going for a Histerectomy and TVT booked on 5 Oct. I thought it would be a cost saving for the Scheme to do this procedure together, but clearly Discovery cant do that sum….. A very painfull problem, according to them "cosmetic surgery). My phycisan wrote motivation letter and explained the importancy of removal.
If you phone them, and asked to many questions which the consultant cant answer, you simply get cutt-off or transferred to "voice automated service.)
Always was a Discovery fan, but not any more!!!!!!!!!!
And guess what?> ANOTHER problem. I was in hospital from 18 Aug till 24 Aug with a DVT (Deep vein thrombosis). Was seen by the dr the 17th and went for a sonar and doppler test the afternoon. That night Dr Kuhn (Withmore and ass) phoned me to give the diagnosis and told me I need to be admitted to hospital. BUT there was no beds available at Cape Gate Medi Clinic. I was only admitted on the 18th. THE SCHEME RULE STATES: IF YOU WERE SUBMITTED TO HOSPITAL AFTER A DOCTORS VISIT, ALL CLAIMS , VISIT AND TESTS) WILL BE PAID FROM HOSPITAL BENEFIT. BUT NO!! DISCOVERY PAID FROM SAVINGS ACCOUNT!!! I WAS TOLD TO GET A MOTIVATION LETTER FROM THE PHYSICIAN TO EXPLAIN THE REASON WHY I WAS NOT ADMITTED IMMEDIATELY. WHICH I DID. NOT GOOD ENOUGH. I WAS THEN TOLD TO GET THE CASE MANAGER OF THE HOSPITAL TO CONTACT DISCOVERY, WHICH HE DID. HE WROTE AN EMAIL AND CONFIRMED EVERTHING. THIS MORNING I RECEIVED THE FOLLOWING EMAIL:
Dear Mrs Coetzee Thank you for contacting us. Claim for Schnetler Van H P J and Partners Incorporated The below claims were processed as follows: | Treatment date | Amount claimed | Amount paid | Rejection code | Paid to | Date of payment
| 17.08.2021 | R2 248.17 | R2 248.17 | - | Provider | 23.08.2021We have received feedback from our Clinical department. They have confirmed that the authorisation cannot be backdated as you were not admitted to hospital from the doctor’s rooms. For this reason, the claim will remain funded from your Medical Savings Account.
DISCOVERY, YOU ARE PATHETIC, USELESS. WITH REGARDS TO MY AUTHORIZATION PROBLEM, I WAS TOLD YESTERDAY, THE PROCEDURE WONT BE PAID, ACCORDING TO SCHEME RULES.
WELL, WHY DONT YOU APPLY THE SCHEME RULES HERE, AND PAY MY CLAIMS THE CORRECT WHY???????????????
And guess what?> ANOTHER problem. I was in hospital from 18 Aug till 24 Aug with a DVT (Deep vein thrombosis). Was seen by the dr the 17th and went for a sonar and doppler test the afternoon. That night Dr Kuhn (Withmore and ass) phoned me to give the diagnosis and told me I need to be admitted to hospital. BUT there was no beds available at Cape Gate Medi Clinic. I was only admitted on the 18th. THE SCHEME RULE STATES: IF YOU WERE SUBMITTED TO HOSPITAL AFTER A DOCTORS VISIT, ALL CLAIMS , VISIT AND TESTS) WILL BE PAID FROM HOSPITAL BENEFIT. BUT NO!! DISCOVERY PAID FROM SAVINGS ACCOUNT!!! I WAS TOLD TO GET A MOTIVATION LETTER FROM THE PHYSICIAN TO EXPLAIN THE REASON WHY I WAS NOT ADMITTED IMMEDIATELY. WHICH I DID. NOT GOOD ENOUGH. I WAS THEN TOLD TO GET THE CASE MANAGER OF THE HOSPITAL TO CONTACT DISCOVERY, WHICH HE DID. HE WROTE AN EMAIL AND CONFIRMED EVERTHING. THIS MORNING I RECEIVED THE FOLLOWING EMAIL:
Dear Mrs Coetzee Thank you for contacting us. Claim for Schnetler Van H P J and Partners Incorporated The below claims were processed as follows: | Treatment date | Amount claimed | Amount paid | Rejection code | Paid to | Date of payment
| 17.08.2021 | R2 248.17 | R2 248.17 | - | Provider | 23.08.2021We have received feedback from our Clinical department. They have confirmed that the authorisation cannot be backdated as you were not admitted to hospital from the doctor’s rooms. For this reason, the claim will remain funded from your Medical Savings Account.
DISCOVERY, YOU ARE PATHETIC, USELESS. WITH REGARDS TO MY AUTHORIZATION PROBLEM, I WAS TOLD YESTERDAY, THE PROCEDURE WONT BE PAID, ACCORDING TO SCHEME RULES.
WELL, WHY DONT YOU APPLY THE SCHEME RULES HERE, AND PAY MY CLAIMS THE CORRECT WHY???????????????
RegardsDiscovery Health Servicing Team
RegardsDiscovery Health Servicing Team