Discovery Health
Claim that cannot be satisfactorily resolved

I submitted a claim to Discovery in November of last year after I had settled an account for wisdom teeth removal. When the claim was processed, one of the items on the claim was missed. After querying the missed item, the claim was reprocessed and an amount was paid to me. A few days later I received a phone call from the accounts department saying that I owed money to Discovery for the amount of around R470, upon investigation, I noticed that when my claim was reprocessed one of the previously correct entries in my claim was marked as code (108). Contacting Discovery again, I was told that they would contact my Surgeon and discuss the issue and get back to me. Neither of these occurred; I ended phoning the call centre numerous times to find out the outcome. Eventually I was told that my surgeon had been called; after calling my surgeon they said that they had not heard anything from Discovery and that the claim I submitted did not have duplicate codes. Yet again I phoned Discovery and asked them to reprocess the claim, this time something else was wrong. This is getting highly frustrating, all I want is for the claim to be correctly processed.

Company: Discovery Health
Country: South Africa
City: Claims

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