Discovery Health
Incorrectly paid claims

For the past 4 years I have been paying one "healthcare professional" (HP) at the end of each month and submitting all relevant invoices to Discovery with a single proof of payment for a refund.

On 3/1/2013 I paid 5 invoices for December 2012, a total of R2155. On 12/1 I received the claims assessment email from Discovery MailRef#562215462# showing they had refunded me for 3 items and paid theHP directly for the other 2 (total R1300). On querying this and requesting a refund I was told that they had not received proof of payment for the claims (yet they had refunded me for the other items!) After more emails and phone calls on 6/2 they asked me to resubmit the accounts and proof of payment for reprocessing with reference number 2717798192. I did this on 8/2 - no response.

Similar thing happened with my Jan claim (submitted 5/2 - assessment MailRef#574562073 - 5 items - 4 refunded to me, one paid to HP (R685)). More emails and phone call to Cindy (8/4), who asked me to send invoices and proof of pmt to her supervisor (Aluta Ngculu). No response until I emailed again.16/4: Aluta said Cindy would call me same day - didn't happen - nothing since. I am still R1985 out of pocket.

Company: Discovery Health
Country: South Africa
City: Head Office

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