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Discovery Health Medical Aid / medical aid

1 South Africa

Good day,

I have been a Discovery client for more than 4 years and now I have had enough of your pathetic customer service. Every time we submit a claim your system responds with some vague or cryptic error message and I have to try and figure out what it means. No effort is made from Discovery's side.

We have been trying to get a claim processed for almost a month now.

My wife phoned discovery on the 18th of January 2019 to get pre-approval for a range of tests. She spent almost an hour on the phone to going through all the codes on the quotation and the Discovery agent ensured her that Discovery would pay for everything in full.

On 29 Jan 2019 my wife submitted the claim with all the necessary information and documentation via the Discovery app

On 30 Jan we received an email stating the the claim was unclear - refno: [protected]
On 30 Jan we received another email stating the only a receipt was received - refno: [protected]
On 30 Jan we resubmitted everything via email to [protected]

On 4 February 2019 we received an email stating that they only received a receipt of payment. This statement was obviously false as we send 3 different documents containing all practice details and codes.

On 4 Feb a had to phone Discovery to try and figure out what was going on. It turns out in the world of Discovery "only received a receipt of payment" means "membership number incorrect".

On that same they we resubmitted everything with the correct membership numbers.

On 5 Feb we received and email with the same message

On 6 Feb we received an email stating again that the claim was unclear

We then received payment for first amount on the invoice. We are still waiting for the second amount of ~ R 2800

11 Feb we received another email stating that the practice details were missing on the submitted documentation - Again a false statement as both invoices that we submitted contained all practice info including practice codes

11 Feb We resubmitted everything again

At this point we are extremely frustrated with Discovery. Every time you send one of these message we now have to try and figure out what went wrong. The message that your are sending to your customers with this level of service is "We just don't care". How about when there is a problem on a claim you phone the client. How about you put in some effort to get the claims processed. We are paying a lot of money every year to Discovery. Every year prices go up but your customer service goes down.

Today I received a statement stating that Discovery is not paying for the second half.

We have had several reference numbers during this process: [protected], [protected], [protected], [protected], [protected].

Feb 13, 2019

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