Discovery Health
Non payment of NON-CDL PMB claims

I was diagnosed with NON-CDL PMB ICD10 I82.8 on 08/10. I paid cash because savings are depleted. I contacted Discovery to ask them what I must do for NON-CDL PMB. They send application form. The doctor completed it and clearly wrote that I had "deep vein thrombosis" in the leg. I contacted Discovery and they send me an approval letter to tell me my condition is approved. On the letter I saw that all the codes authorised was for my abdomen and aorta. I contacted them and told them it is wrong the DVT was in my leg. Got ref number and phoned back one week later still no payment, they said sorry the codes claimed do not match the codes authorised. I explained that the codes authorised are wrong and the DVT was in my leg. got new ref number and later the day e-mail that stated declined again. I phoned Radiologist and asked them about the codes, they said the code claimed is correct 70220 for leg and authorised code is 44205 which is for aorta and branches. Discovery auth is wrong. Statement from Lancet shows ICD10 code I82.8 for blood test but not per line CODE 3805 is authorised but Discovery no pay because Lancet code not on each line. Incompetence, my leg is not in abdomen

Company: Discovery Health
Country: South Africa
City: National

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