PF
Paul F

1 reviews | Active since Dec 2011

06 Feb 2024, 07:46

There are better alternatives

I was a Discovery medical aid member with a comprehensive plan for many years before I opted to downgrade to a hospital plan with them. During all the years I claimed once when skin cancer was diagnosed and I had to have a small operation to remove the cancerous skin. It was a mission getting paid out as I only had the hospital plan at that time. I claimed under Prescribed Minimum Benefits and managed to get paid back about half of what the operation cost me (I got back about R3500). Then about 6 months ago I noticed a rash on my skin which had me worried that I may have skin cancer again. I visited a dermatologist for a check-up and thankfully it was not . Then I tried to claim for the visit under out of hospital treatment. I got all the forms filled in by the dermatologist and submitted the claim. Despite my good record and long-standing membership my claim was declined outright with a single email. When I objected, they did not even respond. That is why I decided to cancel my membership and change to a much cheaper and better alternative.

0
Replies (5)
Discovery Health
Discovery Health's reply06 Feb 2024, 09:34
Official
Dear Paul
 
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 reply06 Feb 2024, 14:40
Official
Dear Paul F 

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team

PF
Paul F's update14 Feb 2024, 05:12
Reviewer Update
Yes, they did contact me. I was told that that they sent me an email at the time asking that the doctor change something on his account. In any case I never received that email so asked that it be sent again.I then contacted the doctor and he amended his account as requested.I sent the amended account and all the other documentation to their oncology and claims department a 2nd time more than a week ago and as I expected no response even though the automated email back indicated that they received my claim and it would be paid within 3 working days.I enquired about payment with another email which they did receive but still no response.
PF
Paul F's update15 Feb 2024, 10:46
Reviewer Update
Still no payment or even response.
Not sure why they sent me this after my post on HelloPeter if they were just going to ignore me -
Dear Mr Fourie Thank you for contacting Discovery Health. Please note that we require an amended account with icd code of C44.9 for the claim for Dr Essop. Please send the account to *** Regards **** **** Discovery Health (Pty) Ltd On behalf of Discovery Health Medical Scheme
Not only bad service but I wasted my time as well as that of the dermatologist.
Discovery Health
Discovery Health's reply23 Oct 2024, 18:17
Official
Dear Paul F 

We have been in contact with you.   

Regards Discovery Health Servicing Team