Discovery System issue

<p>Hello Peter<br />Hoping you can help me with my Discovery Health account problem. My husband has had cancer since April 2014 and he is registered on the Oncology programme since the 8th April 2014. Every year the cancer member is allowed R200,000.00 out of hospital benefits on the plan type we are on which is Coastal core, a hospital plan. He first had oesophageal cancer of which he has recovered exceptionally well and then in 2016 was diagnosed with prostate cancer as well. <br />Our current running year with the oncology programme started 8th April 2016 and during this year he was treated for the prostrate problem. Our bills exceeded the R200,000.00 limit by R70,000.00 for which we are liable for 20% of this amount. However, Discovery have reprocessed the in-hospital account for one of the doctors and this has been incorrectly processed making me liable for 20% of this doctors account.<br />I have called them to explain numerous times since March and April but with no help at all. I then went into the walk in centre in Canal Walk Cape Town on 5th May 2017, having had to take time off work to do this. I sat there for two hours with a consultant who was very pleasant but could not quite understand how I was explaining the problem to her. She called the Oncology department so I had to speak to them on the phone, as they were unable to come and see me at the walk in centre, so I may as well just have phoned them from work. This lady also could not understand the calculations. I supp**** them with a spreadsheet showing the calculations taken off their remittance advices which totals tal**** with mine, but it is the co-payments that they incorrectly allocated making me liable for R11,000.00.<br />I need this problem sorted out as Cancercare are needing to get the R11,000.00 back which was reversed from them when Discovery reprocessed this particular procedure. I am ready to back to the walk in centre next week but feel that I will be wasting my time as all answers I get every week when I have phoned since then is that there is a system issue and this problem is still in process. Surely this cannot take more than a month since my first visit to Discovery and lots of phone calls preceding this. It has been going on for almost two months now. I work for a surgeon and deal with Discovery daily with patient’s accounts and normally find them efficient until you get hit with your own problem and it is called a “system issue” and cannot get resolved, as I said earlier I have given them a spreadsheet with the calculations, all I need is for them to correct their allocations and all will be fine but I cannot speak to anyone who understands normal arithmetic.<br />Rita Hayes</p>