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yashna R

1 reviews | Active since Oct 2013

11 Sept 2022, 21:41

What about Practitioners

Hello.I'm in private practice. I give discounts to pensioners and the unemployed. Recently many patients say that they are unemployed and ordon't have a medical Aid. I give them cash discounted rates, with a receipt.Later I find out that they are on Discovery medical aid.As they claim back. Is this not *****?They are lying to me. They are taking away my bread and butter.I have rent to pay, staff salaries etc.I feel sorry for them. I choose to help. Instead I get cheated. I also get insulted, and my staff gets insulted. If patients have a medical aid they should use it. I dont understand the concept of claiming back from the medical Aid, which only discovery patients do. I submit electronic claims only. With discovery, I have had an incident where their consultants phoned 5 times in 1 day to query my cash receipt.My phone line needs to be left open for patients who want treatment and help.Discovery consultants are telling me to submit the cash receipt to them, who are they to tell me what to do, itis not my responsibility to submit cash receipts after their client/s de*****ed me.Then the consultants tell me to add on other procedures, now I must add other procedures on a new receipt of treatment that I didn't do.They called me about a receipt that was issued in October last year.Almost a year..This is not my issue, only medical aid claims are my concern.Then they tell me there is an issue with my ICD 10 code, if the same claim was submitted via EDI there was no issue. All these annoying calls while I'm busy with a patient because their discovery patients want to cheat us practitioners out of money. Then the above patient phones my rooms and insults my staff and insults me.She threatens me and says, why did I call discovery medical aid and get her information.How did I know she was on Discovery when she marked the card as cash?She said that I violated the POPI act by contacting Discovery.She told me that I'm refusing to issue her with a receipt, she never asked for a receipt.I gave her a receipt last year.She told me that she is going to report me to the HPCSA and the OMBUDSMAN. I want to take a civil case against her. I have contacted Discovery medical aid with this complaint stating that firstly, is this not***** what their patients are doing? Lying for discounts and then getting money back.I asked why their consultants are contacting me in regards to cash paymentstill date they have not given me an answer to the above questions. All discovery said to me was that they don't get involved between me and the patient yet they caused this issue by contacting me.Discovery is passing the buck onto me. This is why I'm choosing this online plat form. They should actually give me a written apology as well as instruct the patient to apologise to me.They should mediate between us.Discovery should tell clients and practitioners that if they want to pay cash and claim back. Clients must pay full Discovery tariff rates.Also lying should not be accepted. It seems like Discovery medical aid have no issue with their clients de*****ing practitioners with big hearts.

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Replies (2)
Discovery Health
Discovery Health's reply12 Sept 2022, 07:38
Official
Dear Yashna R

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 reply14 Sept 2022, 15:53
Official
Dear Yashna R We have been in touch with you to answer your comments. Regards
Discovery Health Servicing Team