Discovery Health
No reply to my unpaid claim

My claim line for Dr. Vermaak on 2013-09-02 has been rejected as a duplicate line/code. The codes used for this claim is 1036/0069 for an amount of R365-32. I have phoned numerous times to query the fact that Discovery will not pay this out as Dr Vermaak has confirmed that this is in fact a valid claim as the surgery was done on both sides of my nose. I have now explained the situation to 5 different consultants. The last two service specialists I was in contact with was Nicole Ludich (Cape Town) and Candice Pillay (KZN). Both explained that 1036 is for bilateral surgery and can only be claimed once. I have asked the, to contact Dr Vermaak and was promised that I would be contacted by 2013-11-08 - still waiting for this call. I contacted Discovery again on 2013-11-08 and on 2013-11-11 I was contacted by Youmna Kha who promised to get back to me before 2013-11-12 - still waiting for call. As I have told the consultants numerously I need this sorted out this month because this is the final month I can claim our Gap Cover. Something seriously wrong here! Discovery will not pay, the doctor claims the claim is valid, so I was left to pay! How can this take more than 7 weeks to sort out?

Company: Discovery Health
Country: South Africa
City: Cape

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