LS
Leander S

1 reviews | Active since Apr 2010

23 Nov 2015, 12:44

Pre Authorisation means nothing

I recently went for in room procedure, and app**** for a pre-authorisation (pre-auth # ***0) beforehand. The pre-auhtorisation was received and I confirmed with Discovery (*** FAZLOEN) that everything will be paid for as on the Quote received from the doctor. I then went ahad and paid for the procedure thinking I would be refunded. <br> <br> After the procedure, come the day I had to claim Discovery refused to pay as they said there was a problem with the ICD10 code... If this is the case how did discovery pre-authorise the procedure as the ICD10 code was valid as on the quote. I spent days and multiple calls trying trying to get information out of Discovery, but I was made empty promises on the phone and had to start afresh describing what happened every time I called. Eventually I reverted back to the doctor to sort out the matter with Discovery, and they paid eventually, but unfortunately it was short by about R4500.00. My question remains why pre-authorise and tell the customer that everything will be covered in full, when it won't.

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Replies (1)
Discovery Health
Discovery Health's reply27 Nov 2015, 14:30
Official
Hello leeserrao,

Thank you for your comment and speaking to me.

We have provided you with clarity on the preauthorization process and confirmation of payment for certain codes. I have sent you an email with the option to have the difference reviewed for payment from your Medical Savings Account.

Please contact us if you require any further assistance.

Kind regards
Sirgree