AN
Abegail N

1 reviews | Active since Jan 2012

12 Mar 2026, 08:29

Subjective Scheme Rates to reduce claims refund: Medical scheme rate changed on review to reduce the amount refundable to me

Same claim once reviewed medical scheme rate changed a code that refunded 100% of the calim to refunding 32% (reducing the approved value by r2200) to lower value to ensure the total claim paid is close to the original claim refunded. The code that was amended was not even the one queried but then I guess medical scheme rates are subjective to ensure that Discovery refunds as little as possible, so now I have to ask myself on a previous claim that only 40% of the claim was paid as some line items had no values paid some with the medical scheme rate being only 7% of the value that the instruction was to pay as little as possible.

Discovery changed a line items to reduce the amount payable to me by r2200

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Replies (2)
Discovery Health
Discovery Health's reply12 Mar 2026, 10:27
Official
Dear Abegail

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


Discovery Health
Discovery Health's reply18 Mar 2026, 18:27
Official
Dear Abegail

We’ve sent feedback to you on email after contacting you telephonically.  

Regards 
Discovery Health Servicing Team