1 reviews | Active since Sept 2012
When SLA's are not met and the company is proud.
I have never had such a miserable experience with a Discovery's contractor and Discovery Health. The specialist told me that I am unable to pay via medical aid after the receptionist had confirmed on the system that I have funds in my MSA. I had to run around looking for an ATM while I was ill just to satisfy a specialists self-centered process. I was immensely disappointed in Discovery's claim box process. I have put the envelope in the box at Sunninghill Hospital on the 02/09/2015 and I was told today that the SLA is 8 days. The specialist's reception never asked me if I would prefer it to be emailed and explain the claims process. I spoke to Thuso Mamdiaana and explained that this is an escalation this morning she understood and promised to resolve the issue. When I called in she said that I would have to wait for three days for them to look into it so this is 8 days of waiting for the box to be collected and still hasn't been as I was at the hospital. Another 3 days for the claim to be processed than 3 days to receive the money in your account. This is 15 days of a company as huge as Discovery to process a claim with the technology and processes that they have.
Thank you for your comment.
As a Medical Scheme it is outside our scope to comment on your experience with the healthcare provider. We are not in the position to intervene with the daily operations of the practice. We do provide tools to providers so that they may confirm available benefits for members, however it remains the decision of the provider on how they wish to be reimbursed for services rendered.
The turn around time for claims that are dropped off at one of our external drop off boxes is eight days. The claims will be on the system and processed within one working day thereafter. Payment will normally be made 2 working days after the claim has been processed on system. You are also more than welcome to email your claims to *** and we will process the claim within 2 to 3 working days.
We confirmed that your claim has been processed and the funds should reflect in your account within the next few days.
Regards
Annelize
Thank you for your comment.
As a Medical Scheme it is outside our scope to comment on your experience with the healthcare provider. We are not in the position to intervene with the daily operations of the practice. We do provide tools to providers so that they may confirm available benefits for members, however it remains the decision of the provider on how they wish to be reimbursed for services rendered.
The turn around time for claims that are dropped off at one of our external drop off boxes is eight days. The claims will be on the system and processed within one working day thereafter. Payment will normally be made 2 working days after the claim has been processed on system. You are also more than welcome to email your claims to *** and we will process the claim within 2 to 3 working days.
We confirmed that your claim has been processed and the funds should reflect in your account within the next few days.
Regards
Annelize
