Bankmed - Inefficient

I contacted Bankmed on 08/01/2018 to find out about optical benefits prior to visiting my optometrist later in the day on 08/01/2018. They informed me that I need to contact PPN as they outsource optometry. I then contacted PPN, who informed me that my plan covers the following, eye test at R545, single version lens at R175 and frames at R850. I took these associated costs with me to the optometrist to ensure I am line with my plan. On 09/01/2018 submitted my claim for refund as I had to settle in full at the optometrist. By this week Monday 15/01/2018 I had not received any feedback regarding my claim and contacted Bankmed to investigate, they then informed me that I need to submit the claim to PPN. I pay my monthly contribution to Bankmed and have also submitted my claims via the Bankmed website, nowhere on the Bankmed website does it indicate the optometry claims must be submitted to PPN. I would expect Bankmed to forward to claim to their outsourced department in order to reimburse the member. Why should I have to run around and speak to 5 different people to get any service!!! I then submitted the claim to PPN, and contacted them on 18/01/2018 to find out what is happening with my claim, they now inform me that they require the prescription and that they contact my optometrist to obtain. When contacting the optometrist to obtain the prescription, they informed me that no correspondence has been received from PPN however I have obtained that prescription - this took me a whole 5 minutes and I have now submitted YET AGAIN to PPN. PPN also informed me that they will only reimburse me R345 as my optometrist falls out of the PPN list. What I fall to understand is if they are willing to refund a PPN provider R545 then why will that not refund me the same value for using another optometrist of choice!!! It would be at my discretion to an optometrist outside the PPN list if they charge over the R545. then is would be for my expense however in this case my us claim is for an amount R541 yet they refuse to pay the full R541. According to my plans guidelines rules listed on the Bankmed website it states"100% of cost, limited to R545.00 pb at any other optometrist", so why are they refusing to refund me the R541 as per my claim?????? I am totally horrified by the level of service, we in SA pay a fortunate to medical aids and receive NO real benefits or service. Seriously considering investing money elsewhere to cover for medical costs then have to deal with this!