Discovery being shady...

[ChrisThomas]

Heya,

So I get this email below, and am wondering, how is this my problem? This is 4 months later?

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We notified you in previous claims communications that we paid Lancet Laboratories an amount of R269.3 for pathology services for Mr (Name) between 20/02/2017 and 20/02/2017.

According to the Scheme Rules, we pay claims for day-to-day pathology services from available funds in your Medical Savings Account (MSA), if you have an MSA. However, in this case, we incorrectly paid Lancet Laboratories from the risk benefit.

We apologise for this error and wanted to send you a note to explain this correction and apologise for the inconvenience this may have caused.

The claim was reprocessed to be paid correctly, but it was rejected as you do not have day-to-day benefits or available MSA funds. You therefore owe Lancet Laboratories the amount that was claimed, which is R269.3. To settle this amount, you will need to make payment arrangements with them directly.

 

[Blu82]

Discovery pioneered the tactic to pay all benefits from day to day / savings first before touching anything else. Since they started it, it has now become an industry standard.

 

[ChrisThomas]

Discovery pioneered the tactic to pay all benefits from day to day / savings first before touching anything else. Since they started it, it has now become an industry standard.

My medical aid costs me R2300 pm - for me alone on the plan.
I have spent over R40k this year on specialists visits and medication where Discovery has rejected everything, as I am dealing with chronic pain that nobody seems to know what to do with, and now they want to hit me with a R300 bill? I would have had no problem paying for it at the time....

 

[Blu82]

My medical aid costs me R2300 pm - for me alone on the plan.
I have spent over R40k this year on specialists visits and medication where Discovery has rejected everything, as I am dealing with chronic pain that nobody seems to know what to do with, and now they want to hit me with a R300 bill? I would have had no problem paying for it at the time....

Before Discovery started their practice the medical aids would have paid a total R40300 of your bills since the specialist fees would not have touched your day to day / savings.

 

[Foxhound5366]

Haha, I got the exact same e-mail yesterday ... only my amount owing now is R800.

It's 100% above board though, we were aware that this was a cost we'd have to pay and were pleasantly surprised when the labs put it through directly to Discovery and it actually got paid.

The moral of the story is: there's only free cheese in a rat trap. Thanks Discovery, thank you very much.

 

[I.am.Sam]

yeah they pay for all blood tests from your savings

way cheaper than paying cash though as discovery has a partnership with these labs

 

[WalkWithMe]

So there was a mistake, picked up in an audit - probably a human error. Then they fix it and you call it shady. If it was the other way around, you will make a noise and the 4 months would be irrelevant. If the rules go one way, then it must surely go the other way too.

 

[ChrisThomas]

So there was a mistake, picked up in an audit - probably a human error. Then they fix it and you call it shady. If it was the other way around, you will make a noise and the 4 months would be irrelevant. If the rules go one way, then it must surely go the other way too.

If you bought a car, and they forgot to charge you for climate control, then 4 months later they want to charge you for it, you're not gonna ask questions?

 

[Kosmik]

yeah they pay for all blood tests from your savings

way cheaper than paying cash though as discovery has a partnership with these labs

Not always. Certain tests are covered in screening and if on chronic, some are covered too. Those I now check like a hawk as my savings were robbed for years even though I was on chronic.

 

[Polly101]

Not always. Certain tests are covered in screening and if on chronic, some are covered too. Those I now check like a hawk as my savings were robbed for years even though I was on chronic.

yes this
make sure the labs code each and every line item to the appropriate disease code, and not just the top line of the invoice

 

[syntax]

Got the exam same email, have tried to contact lancet multiple times for details on who to pay and the account details.
No answer so far

 

[ChrisThomas]

Got the exam same email, have tried to contact lancet multiple times for details on who to pay and the account details.
No answer so far

Same problem on my side, I'm sure they'll soon come after me for their money, I've paid all my accounts with them on time so far so they know exactly who I am lol...