LB
Lisanne B

1 reviews | Active since May 2012

10 Apr 2024, 10:58

Promise to pay for bariatric surgery and then reject your claims!!!

So I got approval for bariatric surgery to be paid for at 80%. Blessed and very happy, until we got to the point of submitting claims for the more than R100K I paid cash upfront to the various medical professionals. Despite the fact that I proved to Discovery that I made the payments and hold an authorisation for the surgery in March 2024, all claims are rejected outright without Discovery checking first whether it relates to bariatric surgery!!! So they delay the process as much as possible and have backlog on backlogs! This is clearly a process failure on Discovery's part, which has a knock on effect on my Self Payment GAP, which I have clearly already paid (the more than R100K). I heard via a medical professional (hearsay) that Discovery does not want to spend any money on this "small" glitch as they have millions of other things to manage. We this is extreme poor customer service! You should have your processes 100% working when you are in fact prepared to pay 80% of the surgery. The hospital was paid only 76.5% why not 80%? When will I be refunded?

0
Replies (2)
Discovery Health
Discovery Health's reply10 Apr 2024, 11:41
Official
Dear Lisanne

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 Apr 2024, 08:02
Official
Dear Lisanne

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

Regards 
Discovery Health Servicing Team