Sports Injury Benefit is a ****

I am on the Classic Smart Plan and my issue relates to the Sports Injury Benefit which according to their brochure on the benefit includes the following:

"Upon activating the benefit, you will have access to the following healthcare services: • Unlimited basic black and white x-rays • Two specialist consultations per person per year when referred by a Smart Network GP • Four consultations per person per year to a physiothe******, biokineticist or chiropractor when referred by a Smart Network GP."

Seen here: https://discoveryhealthmedicalscheme.co.za/wcm/discoverycoza/assets/medical-aid/benefit-information/2024/sports-injury-benefit-on-the-classic-smart-plan.pdf

Earlier in April I dislocated a finger while playing soccer, I subsequently saw Dr Giles King who activated the Sports Injury Benefit and referred me to get xrays done, after receiving the report Dr Giles King then referred me to a specialist, Dr Dirk Van Der Spuy, who then referred me to a the******, who I saw twice.

In short: GP activated SIB, referred me to Xrays, GP referred me to Specialist, who referred me to a the******.

I have submitted claims for the Xrays, specialist, visit, and the****** separately. Then tried again as a single submission. Tried variations, added the screengrab from the GP which included the ICD 10 codes. Nothing, it's not getting approved.

I have tried submitting on both discovery and discovery health apps, and per email to claims@discovery - who just haven't responded after 2 weeks.

It's worth adding here that the claims submission process on the apps doesn't have any way of listing ICD 10 codes, which means if there's a mismatch on an invoice, you just hope it's not an issue.

I am going to share this review on as many discovery health social media posts as I can until my claim is settled.