Discovery Health
Claim in respect of dental procedure followed

My husband underwent a dental procedure during September 2012 at Eugene Marais Hospital. A wrong code was captured by the hospital when the claim was submitted and the claim was rejected. The hospital send me a letter of demand for outstanding account. It was then discovered that claim was rejected due to incorrect code used. The claim was resend. In February 2013 I received another letter of demand. Claim was not processed correctly. yet again the code issue came up. I had numerous discussions with Discovery whereby I was told that an incorrect code was used by the hospital when the claim was done. I was told that I am not responsible for an access amount which were added by Discovery after the claim was queried. Discovery said the Accounts manager will sort the claim out with the hospital. I received another Letter of Demand from the hospital as the claim was only partially sorted out. Nobody communicated to me that there is still a problem. The hospital recon that Discovery is not rectifying the claim on their side. Could you kindly intervene in rectifying this claim as it is 6 months since the operation and various calls to both parties.

Company: Discovery Health
Country: South Africa
City: Pretoria

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