RATING OPTION OF 0 (ZERO) NOT AVAILABLE TO EXPRESS MY DISGUST WITH CUSTOMER SERVICE PROVIDED BY DISCOVERY HEALTH

Item: Discovery Health
Rating: 1

This will be second complaint on the same issue as it seems Discovery decides on a daily basis what they require in order to pay back a claim (FROM MY SAVINGS ACCOUNT) for a vaccinne (HepA & typhoid) that i got as a precaution for travel to China - total amount due is R675 - wonder how much it will cost DH should I come back with an infection? History thus far: 1. Vaccinated on 6 April 2016 2. Claim submitted on 8 April 2016 3. After 2 weeks no payment - DH consultant informs MKem that ICD code is needed 4. Claim re-submitted with 2-3 day payment promised 5. Next requirement - provide a Nappi code 6. Claim re-submitted with 2-3 day payment promised 7. Next requirement - practice no. of GP 8. Claim re-submitted with 2-3 day payment promised 9. Completely lost is at this point and logged the first complaing on Hello Peter 10. As a result from point 8 got contacted by DH with the request to resubmit all the surpporting do***enation again 11. Just received a call with a BRAND NEW REQUIREMENT - DH now want the practice number of the clinic sister that administrated the vaccine - why wasn't these requirements listed by the original consultant (point 3)? 12. Second complaint on Hello Peter logged 12 May 2016 - not sure if it will help in my case, but would like to warn people considering DH to THINK TWICE before chosing them as a service provider

Helpful (0)

Replies (1)

Discovery Health's replyOfficial

13 May 2016, 10:23

Thank you for allowing us to address your concerns. We can confirm that when a claim is submitted to the Scheme, certain information is required. This information is not available and has caused the claim in question to be rejected. A valid claim must include the following details: • Your membership number • Patient’s name • Healthcare provider’s name • Healthcare provider’s practice number • Referring Healthcare providers practice number • Account number • Treatment date (on each claim line) • Tariff/Procedure codes (on each claim line) • ICD 10 codes (on each claim line) • Amount claimed (on each claim line) • Total amount claimed Should any information not be included in the claim the claim will be deemed invalid and rejected. This information is required as stated in Medical Schemes Act and Scheme Rules. Regards Discovery Health Servicing

Discovery Health's reply13 May 2016, 10:23

Official