Discovery Health
Claim not paid after required info sumbitted!

I was admitted into hospital in January this year and I needed a MRI Scan of the Brain done. I was on a plan that covers this in hospital. I spent a week in hospital waiting for authorization to be granted even though there was no outstanding information and this was the 1st time that I had such a claim. Authorization was eventually given but Discovery short-paid the claim. The reason for short-payment was that the scan was requested by a GP and not a Specialist. I was attended to by a Neurologist in hospital and to my knowledge this is considered a Specialist doctor and not a GP. I got Lancet to update the invoice to reflect that the doctor who requested the scan was a Specialist Neurologist and I asked them to resubmit. Up until today, Discovery has still not paid this claim! I have cancelled the policy because I am disgusted with the service that I have received! I had to take out a new policy with them because of my new employer but if I had a choice I would not be with Discovery after the way they have treated me. They have also listed me on ITC for funds owing to them BUT they don't pay what they owe to me! Disgusting!! I am looking at forwarding the matter to the ombud.

Company: Discovery Health
Country: South Africa
City: Durban

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