Emergency surgery not enough for PBM.

My husband went in for an emergency surgery (March 2026) on his bicep at Montana Hospital (this is on the network list). The dr's did a sonar which determined he needed immediate surgery otherwise he could lose the function of his arm, which was already black with blood. We were under the impression that going to a network hospital as we should, that every Dr. there will be covered by the medical aid. We were wrong. He did not have a choice in Dr's. There was only one put on the case. Turns out the Dr. and anesthesiologist was not on the network list (we did not know this. If this was in all the paperwork they just pushed in his hands before surgery, no one in their right mind who is currently stressing about the surgery, not even getting to see his wife before going in as this was not planned, will see any such information).

Now in October, there is still an outstanding balance of +-R5000 for the anesthesiologist as the codes used does not seem "emergency" enough. Now we have phoned the medical aid who advised we call the Dr. we've called the Dr who said they will write a motivational letter. This was sent in July 2026. We have not received any feedback. So we started following up with Bestmed in September. Yet to this date still no feedback. I'm the one that keeps reaching out to follow-up, by which we are only informed it has been forwarded to the PBM department.

Tell me how long does it take to understand that the internal bleeding, losing the function of his arm if left untreated does fall under PBM?

Or tell me how, and this is for every other member out there, do we keep this from happening again? What was the correct steps that he was suppose to take lying on a hospital bed in pain? What questions should he have asked or stated to ensure that the rates charged or the Dr's put on the case is within your range and network list???

This is the worst service I have experience to date with this medical aid.