dD
deon D

1 reviews | Active since Feb 2010

12 Feb 2016, 08:28

Trying to shift hospital related claims to members

I have inside information that Discovery is on a mission to reject legitimate claims so ******** members should pay for them themselves. This is a disgrace from a company praising themselves on how good they are. My baby was born in hospital and put on the medical aid. She also went to hospital 2 weeks later for being sick and in both cases Discovery rejected the Pathology claims requested by the in-hospital doctor via Ampath with a reason code of 273 : \We have not paid for the amount claimed as you do not have a Medical Savings Account for this year. Please pay your health partner the outstanding amount if you have not already.\" We all know this is a hospital admission related account and has to be paid from the hospital benefit and they admitted the claims were wrongly assessed and will be re-assessed. EVERYONE - TAKE NOTE OF THIS PRACTICE and make sure you do not allow pathology ( blood tests, etc ) while in hospital to be paid from your MSA. Luckily I do not have a MSA so this bounced back to them. If I had a MSA I would have paid for it unknowingly. I will be taking this complaint to the Medical Council also, so members can be informed of their rights in their contracts."

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Replies (1)
Discovery Health
Discovery Health's reply12 Feb 2016, 09:59
Official
Hello deonroel,

Thank you for your comment.

We are currently investigating your query and will provide feedback shortly.

Regards
Meryl