NCR: Discovery Health and ICD-10 Codes

[markStockton]

For everyone sick and tired of Discovery rejecting claims based on the ICD-10 codes, here is the link to the World Health Organisation database. http://apps.who.int/classifications/apps/icd/icd10online/

 

In my case there was absolutely nothing wrong with the codes provided by the physio, and thus the fight started.

 

[Gasping]

Discovery Health have a strict policy of not paying anything they can get away with. If the ICD-10 codes were correct, give them hell and demand payment according to your plan which is a contract.

 

If the ICD-10 codes are incorrect, give your health care professional hell. My GP got the codes wrong, and when he tried to claim from me 6 months down the line, I told him to go and get knotted.

 

He did.

 

Most people will not fight Discovery. Keep calling in. Eventually you will find a call centre agent that understands and will authorise the payment.

 

As I said, give them hell.

[porky]

Yah, sometimes I wonder why in SA we always have to shout and scream and threaten to get things done.?

 

My father in law has arterial problems with limited blood flow to his legs and has to take chronic medication, Discovery refused the chronic application saying the medication was not on their list of applicable arterial disease medications.!!

 

I couldnt believe it, the medication was prescribed by a Professor and a cardiologist, how much more do they want.

 

I phoned the call centre three times to get an explanation, just got the same answer each time "its not on our list", the fourth time I hit the roof, I shouted and screamed and threatened and demanded to speak to the head doctor, at first they didnt want to allow it, but after hearing how furious I was they put me through, explained the isse and he said he will look at it.

 

Two days later it was approved albeit with a limit, never got an apology a sorry, nothing.

 

Next year I am moving him to Fedhealth, my entire company are on the scheme and when I spoke to them, they already approved the medication for chronic.

 

[Evan Andreou]

Think Discovery is not the only scheme with inadequate reserve levels, the squeeze is on

[Weekend_Warrior]

U all want to get everything for nothing, thats where the real problem lies! Weekend_Warrior2009-09-10 04:47:47

[Evan Andreou]

U all want to get everything for nothing' date=' thats where the real problem lies! [/quote']

Discovery premiums hardly qualify as 'for nothing'

[Gasping]

U all want to get everything for nothing' date=' thats where the real problem lies! [/quote']

 

I pay my subscription every month in full. What do I want for nothing? Discrobery wants my money and then gives nothing in return.

 

I take it you are employed by them?

 

 

[Karl Beaton]

if all else fails email Neville (nevillek@discovery.co.za) ... MD

[Weekend_Warrior]

Well then let me rephrase that u want to pay as little as possible and get as much as possible.

 

All u need to do is check b4 hand what u get for your money then stick to the contract you signed.

[Weekend_Warrior]

I pay my subscription every month in full. What do I want for nothing? Discrobery wants my money and then gives nothing in return.

 

I take it you are employed by them?

 

 

 

Dont think just because i have never had bad service from them or because i go about making my claims correctly that i am in their employ

[Capricorn]

WW: u call paying massive monthly fees to our health insurers pining for something for nothing?

here, take this call: it's your proctologist, he found your brain.

 

but no worries hey, the National health insurance scheme will save us all. Not like we will be forking out more in taxes in return.

[Gasping]

Well then let me rephrase that u want to pay as little as possible and get as much as possible.

 

All u need to do is check b4 hand what u get for your money then stick to the contract you signed.

 

And the problem with this is what? Have you never asked for a discount on anything ever in your life?

 

Get a grip. EVERYONE wants to pay less and receive more. This is what business is all about. You can charge more but offer better value for money and still get the business.

[Weekend_Warrior]

WW: u call paying massive monthly fees to our health insurers pining for something for nothing?

here' date=' take this call: it's your proctologist, he found your brain.

but no worries hey, the National health insurance scheme will save us all. Not like we will be forking out more in taxes in return.

[/quote']

 

U are more than welcome to join the National Health Service.

 

I get what i pay for with Discovery nothing more and nothing less. 

 

[Capricorn]

u totally missed my tongue in cheek comment about the NHI scheme. Well, it seems you've never needed to test the limits of your health insurer. count yourself lucky, but dont belittle the genuine problems faced by others when the insurance gets stingy, and they do. If you dont ask, you wont know.

[Weekend_Warrior]

Have you never asked for a discount on anything ever in your life?

 

 

I have yes but if i dont get the discount i dont get all angry and start writing about it on thehub.

[Weekend_Warrior]

u totally missed my tongue in cheek comment about the NHI scheme.

 

No i never, i just forgot to change to sarcastic font