********* PAYMENT EXPECTED AFTER FOUR MONTHS

<p>I was contacted earlier this month by Discovery to pay a claim from February 2017 that the "mistakenly" transferred payment to Lancet Laboratories from my "Risk Benefit" and not my "MSA". They admitted this error and were very sorry, but I was now liable - even though I had more then sufficent funds in my MSA in February 2017 (over R10 000). </p> <p>Now in June (four months later might I add), I no longer have savings in my MSA. They now want me to pay Lancet for the claim in February 2017, as they tried to take it off my MSA and I have no funds. I mean seriously?????? How on earth do they think this is ethical?????</p> <p>It is not my mistake - it was theirs! Different story if I had no funds in February 2017 - but I more then sufficient funds!</p> <p>I have been back and forth to their Claims divsion, even getting our own Company Corporate Discovery guy involved and even then - they now say that "Management" have agreed, that I am still liable.</p> <p>What Organisation in their right mind thinks that this is "ethical". I have chatted to many "normal" folk all over who agree that this is ridiculous and that they would also fight to the death.</p> <p>As a Client of Dicovery for many many years, this does not even help either - as they simply do not care and are prepared for a bad review for 500 measly Rand.</p> <p>I am disgusted and so very disappointed in Discovery Health. I honestly feel like switching Providers to another Company who actually gives a damn and does no pawn off their internal errors on innocent Clients.</p> <p>If Management had actually "seen" my email - I know for a fact that they would agree with me - as asking me to pay for their mistake is pathetic.</p> <p> </p> <p>Below is a copy of the latest reply I received:</p> <p> </p> <p>Thank you for contacting us. <br />Membership number: ********** 40 <br />Reference number: ********** 775 <br />Claim for Mauff A C and Partners <br />The claim for the above mentioned provider has been processed as follows:<br />Service date Date received Amount claimed Amount paid Paid to Reason code Released for payment <br />27/02/2017 02/03/2017 R502.90 R0.00 - 276 -<br />Reason code 276: We have not paid for the amount claimed as the member ran out of funds in the Medical Savings Account (MSA) and has not yet reached the Annual Threshold. The member is responsible to pay the outstanding amount. <br />We have contacted the member who has advised that she will not be held liable for the non-payment on this account.<br />We are aware that there were available funds in the MSA at the time the claim was received and processed.<br />However, this error was not picked up in March 2017, it was picked up in June 2017.<br />Our Auditors receive their auditing reports every 4-6 months, which include claims which have been incorrectly processed for a number of reasons.<br />These claims are then manually reversed and reprocessed accordingly, based on the different plan types and the Scheme and billing rules.<br />We have reviewed this with management and the member will remain liable for the costs, as out-of-hospital pathology is payable from the MSA and Above Threshold Benefit or from the member’s own pocket if there are no funds available.<br />We sincerely apologise for this claim error and the inconvenience caused. We are doing everything possible to ensure that this does not occur again in the future.<br />If you have any more questions with regard to this query, please email ********** and quote the above reference number as well as the membership number. <br />Regards<br />Mellisa Pullen <br />Discovery Health (Pty) Ltd <br />On behalf of Discovery Health Medical Scheme </p> <p> </p>