1 reviews | Active since Nov 2012
Struggling for 4 weeks to get a claim processed - Unhelpfull agent Amanda
I had a virtual consultaion on 7 November with a GP within the Extender Benefit network as my MSA had depleted for the year. To my knowledge and upon enquiring I was informed that I have 6 consultations for the year on the Extender Benefit. The doctor referred me to a network GP for a physical consultaion and I saw this doctor on 18 November. The doctor whom I saw on 18 November's claim got rejected. Upon enquiring, I was informed that the claim for the virtual consulation on 7 Nov was also rejected, that doctor had to re-submit correct soap notes and after that, the claim from 18 Nov will also be paid as it falls under the Extender Benefit. I have been communicatiing with Discovery since 19 Nov to get this resloved and spoke to Hloniphile, Dazree, Zakkiya, Chante, Misa all who were helpfull giving me updates on the progress. I eventually spoke to team leader Siya from the 1st line escalations division and lastly Eileen who called me back to inform me all was in order, the claims will be paid and she will also inform both doctors practices that the claims will pay so they can stop calling me for the money. Yesterdauy I got an e-mail for the claims and the one dated 7/11/2025 was paid in full and the one dated 18/11/2025 was partially paid. I enquired yesterday as to why it was only paid partially and spoke to Amanda and she informed me the claim paid from the Personal Health Fund and not the Extender Benefit. I was fruastrated that I had to explain this situation again and asked her to re-process the claim and to be called by either Eileen or a Team Leader as this has been dragging on. She said she doubts the medical aid will pay as the claim has no referring provider but I insisted that she still log the claim irrispective of whether she doubts that it will be paid and I asked for a reference number. She said she'll e-mail Eileen to call me and there were no team leaders available of which I found hard to believe. I also told her that of everyone that have been assisting me througout this query and that she is the first person who doesn't have a team leader available and is unable to arrange a call back. She also never gave me a refernce number. Can Discovery please process these claims correctly so the doctors can stop harrasing me for their monies. I can be reached on ***
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Regards Discovery Health Servicing Team
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
We have been in touch with you to answer your comments.
Regards Discovery Health Servicing Team
We have been in touch with you to answer your comments.
Regards Discovery Health Servicing Team
