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trevor.fourie trevor.fourie

1 reviews | Active since Nov 2016

21 Jun 2018, 11:41

This is your last chance or I will pursue this further

<p>Yet again you guys are jeopardising the my son's recovery! I have in my whole life not met a MORE *********** company then you! It's a shame that I am being FORCED to you use you through my company! On the 07th of May 2018 at 09h46 I send an e-mail to your PMB Department requesting aurhorisation for my son's clubfoot shoes. On the 8th of May at 15h20 I received an e-mail back with authorisation form stating that the PMB has been approved. On the 11tf of May 2018 at 14h51 after receiving the invoice from STEPS. I forwarded the claim for approval with the invoice as well as the PMB approval form through to your claims division. On the 17th of May 2018 at 16h00 i received an e-mail stating that X with be deposited to my account for the claim. On the 19th of May 2018 at 02h25 I received a notification that (X - 90%) LESS THAN 10% of the amount stating that would be paid has been paid to my account. I contacted Discovery on the 21st of May 2018 at 9h43 &amp; spoke to ***. She informed me that i own an X amount to Discovery for a claim they paid both to me and the supplier in 2016. I informed her to check her records again as Discovery NEVER paid the supplier! In fact, had I waited for you guys to pay my son would have relapsed with his treatment after all the operations due to your "internal processes". I informed&nbsp;her, that I paid the supplier in full and Discovery re-imbursed me minus R1100 as originally approved and authorised. I also informed her that all the problems on this matter was sorted and resolved in April 2017 by their HEAD OFFICE which took me more than a year to sort out and point out to Discovery where they stuffed up! So in short to add injury to insult. Not only did you pay me out less than 10% of the approved amount BUT you also deducted it from my MSA and not the PMB FUND! Mokgadi would have contacted me back to advise regarding this matter. I phoned again this morning at 8h44, and spoke to ***. She came back to me after me holding on for 30 minutes and advised now that the claim for STEPS was erroneously paid to me and they reversed the amount as the claim had been reversed, which means I owed them the money back. I asked&nbsp;her how they reversed it since it was Discovery that dealt directly with STEPS on this claim due to numerous mess ups! They (DISCOERY) dealt with them in getting the information, so HOW can they reverse a claim where THEY got the all the information needed! She advised will take this up with their head office and get back to me in 10 minutes. I advised her to take the whole day to sort this out once and for all and get back to me. Received call on 25 May 2018 at 8h58 from Heelan on and again explained the whole situation again to him. He would have looked into it and get back to me. Too date I am still waiting for a response. CLEARLY YOU DO NOT UNDERSTAND THE CONCEPT OF CLUBFOOT RELAPSE AND THE URGENCY OF THE MATTER. This will be my final attempt to resolve it as per the Council for Medical Schemes recommendations. If not I will forward all documentation and correspondence (including that from your CEO on the all the **** you caused) to the Council for Medical Schemes. I will then also pursue this legally as this is the 2nd time since the birth of my son 20 months ago, that you have now put his treatment and health at risk due to your incompetence and inability to do YOUR JOB!</p>

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Replies (5)
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trevor.fourie trevor.fourie's update21 Jun 2018, 12:01
Reviewer Update
"... I phoned again this morning at 8h44, " - was the 23rd of May .. not this morning
Discovery Health
Discovery Health's reply21 Jun 2018, 12:20
Official

Dear trevor-fourie

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 reply25 Jun 2018, 16:14
Official

Dear trevor-fourie

We have been in touch to answer your comments.

Regards
Discovery Health Servicing Team

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trevor.fourie trevor.fourie's update26 Jun 2018, 09:54
Reviewer Update
Correction. You have been in touch with me to get the relevant information. Nothing has been answered or resolved as yet.
Discovery Health
Discovery Health's reply26 Jun 2018, 14:46
Official

Dear trevor-fourie

We received your message and we’re looking into the matter.

Regards
Discovery Health Servicing Team