Refusal to pay

Failure to pay PMB claims

Last month I underwent a PCR test for Covid-19. I tested positive. Covid-19 is a PMB level of care. Despite this, my claim was rejected by Discovery as my benefit for Covid-19 tests was said to be exhausted. However, given that the test was positive and that Covid-19 is PMB level of care, the test should be paid irrespective of whether my benefits are exhausted.

I have called the contact center. They are oblivious to PMBs. I am now at the point where I have to prepare a CMS complaint over what should be a very simple matter were it not but for the incompetence of the call center staff.

Please can someone assist.