MP
Mike P

1 reviews | Active since May 2012

13 Jun 2023, 12:16

The Claims notification is TERRIBLE - and designed to keep the client in the dark

I am on Discovery Classic Comprehensive. I receive a Claims Notification which is absolutly beyond useless. My doctor or pharmacy (or ANY other medical facility), submits the bill to Discovery, they may pay some and usually not all. I then get a claims list which just says the date, patient name etc - it does NOT SAY WHAT THE CLAIM IS. Thus when I try to ascertain what item has not been paid or why it is paid from MSA instead of the SCHEME, it is almost impossible to figure this out without going back to the doctor/pharmacy/hospital to get a detailed listing. Even then I have to check the amounts rahter than the procedure as this is the ONLY way to figure out the bill. I am convinced Discovery does this to obfusticate the claims procedure. I have tried NUMEROUS times to get them to detail the claims propoerly, they simply do not do it. BTW PPS used to detail each cliam FULLY so that you know exactly whats happening. Discoivery - Truly a horrible Medical Aid. End of the year back to PPS

0
Replies (4)
Discovery Health
Discovery Health's reply13 Jun 2023, 14:09
Official
Dear Mike

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 reply13 Jun 2023, 16:32
Official
Dear Mike
 
We have been in touch with you to answer your comments.
   
Regards
Discovery Health Servicing Team
MP
Mike P's update13 Jun 2023, 18:28
Reviewer Update
Good day and thanks for the reply. You have advised me to send an email to a specific office every time I need more information on my claim.
Please note that there are often numerous claims. To have to email my query to your office each and every time simply defeats to object. I simply do not have the time to waste with such an exercise and I must assume your office would not want to waste similar time.
I SHOULD BE ABLE TO UNDERSTAND AND ANALAYSE MY CLAIM MYSELF! I should not have to send extra emails to understand your claims procedure.
I requested that you escalate this to someone who can provide a really good reason why you make this so difficult for your clients – and PLEASE do not say it’s a POPI thing. We both know that is simply not true. The document to me is password protected. Every detail is on the claim – apart from what the claim is actually about!
Discovery Health
Discovery Health's reply14 Jun 2023, 07:50
Official
Dear Mike
 
We have been in touch with you to answer your comments.
   
Regards
Discovery Health Servicing Team