Theft from service providers

<p>I am a healthcare service provider and submit claims to Discovery Health on a weekly for direct payment to my practice. With each claim submitted I ask/instruct that the claim be paid directly to the practice. 9/10 times this is correctly processed and paid. Every now and again, an administrative error results in a claim being incorrectly paid to the member instead of the practice. I am currently trying to resolve one of these errors and the feedback I have received from Discovery is absolutely disgusting. I was told that they cannot reverse the payment to the member as the funds have already been released. When I asked why my instructions to pay the practice were not followed, I was told that the instructions are not read and whoever is paid, is paid. I asked why members were paid out when no proof of payment to the service provider was submitted. I was told that the responsibility lies with the member to pay the service provider. By that logic, members could submit thousands of rands worth of claims, be paid out by Discovery and never pay the service providers in question. Other medical aid funds require proof of payment to the service provider for the member to be reimbursed. Clearly Discovery could not be bothered to ensure that service providers are not being ****** of their hard earned money (billed at the specified Discovery tariffs may I add!).</p> <p>I am both appalled and infuriated by the total indifference shown as to where money paid out by the scheme lands up. As service providers, we are always in the spotlight regarding how and when we charge our patients. I am complying with Discovery's tariffs to the cent so that I can be guarranteed payment for my services, and they clearly couldn't care less whether that actually happens or whether the members land up with extra cash in their back pockets.</p> <p>My query has been taken up by a supervisor. Let's see what happens...</p>