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trevor.fourie trevor.fourie

1 reviews | Active since Nov 2016

06 Dec 2021, 17:14

THE WORST COMPANY!!!

My 5 year old son went in for a hospital procedure on the 18/10/2021. On the 14th I was advised that surgeon would be paid from my hospital benefits. "The related accounts, which include the dental surgeon’s account, will be paid from your Hospital Benefit" and was informed no Pre-Auth was required.

Good thing I did not listen to this and got the pre-auth number. ***). The claim was paid by me and submitted to Discovery on the 20/10/2021. It was declined due to insuff fund in MSA (even though your agent said from Hospital Benefit).

I then spoke to another agent Scelo who informed me that was not the correct reason but because the Hospital Code was not given on the claim. So I obtained it from the dentist and resubmitted the claim on the 18th of Nov.

The claim was then declined again .. now saying that the POS Code was not showing. So AGAIN I contacted the dentist and they send the statement with the codes required which I also send through to them on the same day (30/11/2021).

Each time saying that it will take 2 to 3 days.

Today I contacted Discovery again .. and guess what .. Now you paid the dentist AFTER I SUBMITTED THE PROOF OF PAYMENT BY MYSELF on the 20/10 AND the 18/11, AS WELL AS THE STATEMENT SHOWING THAT I PAID IT!

Now you tell me it will take ANOTHER 3 days to correct this!

If this claim is not paid in the next 3 days (of which I'm counting today) and you STOP WASTING MY TIME I will take this to the Council for Medical Schemes .. I'm so ##$## tired of this EVERY SINGLE TIME!

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Replies (4)
Discovery Health
Discovery Health's reply07 Dec 2021, 07:26
Official
Dear Trevor F
 
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 reply09 Dec 2021, 09:29
Official
Dear Trevor F
 
We contacted you to discuss your query.
 
Regards
Discovery Health Servicing Team
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trevor.fourie trevor.fourie's update10 Dec 2021, 10:43
Reviewer Update
Yes ... on Tuesday I was informed that the funds have been paid and would reflect in my account Wednesday. Then on Thursday I was again contacted and advised that the funds have been paid and would reflect in my account on Friday. So at this stage you are just BLATANTLY LYING TO ME over the phone.

NICE STALL TACTIC .. keep telling the client it has been paid to check the account tomorrow.


Discovery Health
Discovery Health's reply14 Dec 2021, 16:22
Official
Dear Trevor F
 
We have been in contact with you.
 
Regards
Discovery Health Servicing Team