TS
Tamsyn S

1 reviews | Active since May 2014

22 Mar 2019, 11:38

Staff not only untrained, but rude and unhelpful.

I am a service provider (practice number ********** ). I charge Discovery rates and am registered with the scheme to receive payments for claims.

I submitted a claim for a member (member number ********** 00) in February that was incorrectly processed by Discovery Health (for the Netcare medical scheme) - it was short-paid and it was paid to the member instead of the practice. After contacting Discovery countless times in this regard, I was eventually provided with the member's email address and told that they had agreed to pay over the money to me and I should contact them directly (I was contacted by Sandile). This was on Monday 11/03/2019. I emailed the member about 4 or 5 times with no response. I then emailed Discovery/Netcare again to explain that I have tried to get in touch with the member, they are not responding and I thus cannot get my payment. Today 22/03/2019, I received an email from Thabo Mojaki (WRefNo# ********** 220# / MailRef# ********** 304#) stating the following: "We have tried to contact the member to no success, kindly contact the member to make further arrangements. Please note to avoid payment to be paid to the member, provider should register on one of our payment arrangements." Dear Thabo 1) I explicitly told you I have contacted the member countless times with no response. 2) I am registered for payment with Discovery which is why I charge Discovery rates. 3) The payment to the member was an error 100% on the part of Discovery.

My level of frustration and disgust with Discovery has reached new heights. I am playing ball. I am charging their rates and complying with their rules. What do I get in return? Processing errors, payment errors and, worst of all, rude and untrained staff who send generic emails without even bothering to understand the situation at hand. Thabo - your email has raised my blood pressure to a dangerous new high.

0
Replies (3)
Netcare Medical Scheme
Netcare Medical Scheme's reply22 Mar 2019, 13:45
Official
 
Dear Tamsyn 
  
We received your complaint and we’re looking into the matter. 
 
Kind regards 
 
Netcare Medical Scheme 
TS
Tamsyn S's update22 Mar 2019, 13:48
Reviewer Update
I have now received an email from Jamy Kleinbooi at Discovery Health suggesting that I take legal action to get my money from the member! So now I must pay for a lawyer to get money that Discovery should have paid directly to me from the start??!!
Netcare Medical Scheme
Netcare Medical Scheme's reply25 Mar 2019, 11:32
Official
 
Dear Tamsyn 
 
We can confirm that your query is now resolved. 
   
Kind regards 
  
Netcare Medical Scheme