TS
Tamsyn S

1 reviews | Active since May 2014

05 Feb 2018, 06:27

Too lazy to check for correct coding

For the second time and one month I, as a service provider, have had the same experience. I submit a claim to Discovery for payment (being careful to charge their rates to the cent). They in turn are hasty in processing the claim and fail to see that 1 or 2 of the time codes (of the 10 claim lines) is different from the others, resulting in it appearing to them as if I have overcharged and the payment then defaulting to the member. It then becomes my problem to get the claim reversed and paid to my practice. I am sick and tired of this inefficiency followed up by snooty calls from the call centre about having to get permission from the member to reverse the payment - not my problem! Come on Discovery - if I am playing by your rules (and your rates), the least you can do is be efficient with claims processing and payments.

0
Replies (4)
Discovery Health
Discovery Health's reply05 Feb 2018, 08:30
Official

Dear TS7

We are sorry to hear about your frustrations. We are investigating your case and will get back to you as soon as possible.

Regards
Discovery Health Servicing Team

TS
Tamsyn S's update06 Feb 2018, 15:33
Reviewer Update
The response from Discovery in dealing with this matter is totally unacceptable as they have no palmed the responsibility off onto the member (who was short-paid due to the processing error anyway).
Discovery Health
Discovery Health's reply07 Feb 2018, 15:19
Official

Dear TS7

We have sent you feedback via email.

Regards
Discovery Health Servicing Team

TS
Tamsyn S's update09 Feb 2018, 13:28
Reviewer Update
I am still waiting for acceptable resolution of this issue. On Wednesday 2 separate people called me with various gratuitous comments, explanations and promises of assistance. This morning I see on the website that the balance of the claim (now correctly processed) has also been paid over to the member! This is totally unacceptable, yet the consultant on the phone seemed to find it amusing and informed me that the member's husband understood that it was "human error". I will be forgiving of the "human error" when the amount is paid into my account by Discovery.