Deeply Disappointed and Losing Trust in Bankmed

I am writing to express my disappointment and frustration regarding the handling of a recent claim relating to an emergency procedure that I underwent. I recently received an outstanding account from one of the doctors involved in my procedure. Upon reviewing the claim, I noted that Bankmed made only a partial payment, stating that the doctor was not contracted to the scheme and that payment was made at the scheme rate. When I contacted Bankmed on Friday to understand why the account had not been settled in full, I was advised that the procedure was not considered an emergency. This response left me extremely confused and concerned. According to the doctor's statement, the claim includes descriptions such as "Emergency Procedure" and "Emergency Consultation/Visit Away." This directly contradicts the explanation I received from the consultant. If the service provider classified the treatment as an emergency, why am I being informed otherwise? On the day in question, I attended the doctor at approximately 09:00 and was admitted straight to theatre thereafter for the procedure. From my perspective, this was clearly urgent medical treatment that required immediate intervention. I would appreciate a detailed explanation of how Bankmed determines whether a procedure qualifies as an emergency and why this claim was excluded from that classification. What is even more frustrating is that all the other doctors involved in the same procedure appear to have been paid in full, while this specific provider has been short-paid. I would like clarity on why different payment approaches were app**** to healthcare professionals who were part of the same treatment event. This experience has been extremely stressful. Prior to the procedure, I also experienced significant difficulties obtaining an authorization number. Now, after the event, I find myself having to scrutinize claim statements and query payments to ensure that claims are being processed correctly. As a member, I expect transparency, consistency, and support during what was already a difficult medical situation. Instead, I am left with an unexpected outstanding balance and conflicting information regarding my claim. I am deeply disappointed by this experience and have unfortunately lost confidence in the way this matter has been handled. I trust that Bankmed will investigate this matter thoroughly and provide a comprehensive response. At this point, I honestly do not want to contact the call centre again, as I have received information that appears to contradict the details reflected on the provider's statement. Rather than gaining clarity, I was left with more questions than answers. As a member, I should not have to feel this discouraged when trying to understand a claim relating to a medical procedure. On top of everything, I have a claim from clicks. I paid for my childs chronic medication because they declined it as per the pharmacist from clicks. I now look at the statement and realized that they made the payment. How when you declined the payment? I don't even know what to say