DR
Dewald R

1 reviews | Active since Feb 2013

30 Oct 2015, 15:48

Refuse to pay PMB claim from risk portion

I had a claim for a prescribed minimum benefit condition and discovery refuse to pay it from the risk portion, but paid it from the medical savings account instead. I have called many times and the call center is unable to resolve my query. They promise to call back but never do. They let me hold on for extended periods. They cut me off when I hold. The don't want me to speak to a manager. They do not want to listen to reason (or the person just don't understand). Apart from that they take unacceptably long periods to process claims and some do not even get processed. Their overall service is just very bad.

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Replies (1)
Discovery Health
Discovery Health's reply01 Nov 2015, 17:12
Official
Hello dewaldvan,

Thank you for your comment.

I investigated your query regarding the claim you are referring to and confirmed that it has since been reprocessed accordingly. One of the codes related to the claim falls outside the approval dates and have therefore funded from your day-to-day benefit. I have emailed you more details around this and you are welcome to let me know if you have any concerns.

I am truly sorry for the inconvenience and delays experienced and assure you that this is being looked into.

Regards
Rishana