Ill communication, non payments, not approving correct codes

I'm highly disappointed in BestMed.

I had an operation to remove the pin from my lower left leg in December 2025. First, the medical aid FAILED to ask for the correct X-ray (which was the first X-ray report taken when I had my accident 6 years previously, which they do have record just too lazy to find). This was 2 weeks of pure unnecessary stress before the operation. Never mind the pain I had to live with at that time.

Then the underwriters did not approve the cutting open of the old healed wound scar to take out the actual pin. According to them the code meant a "septic wound" but the doctor disputed this, saying it's the correct code. I, as the member, am the only one BestMed wants to speak to since they claim the POPI Act prevents the doctor's offices from speaking directly to them. This is BS. As a member how must I know the codes only used between medical aid and the doctor? Second, how did the medical aid want the doctor to remove the pin that was inside of my leg bone without cutting me open? With magic?

Now I had to pay that non-approve code because the medical aid did not approve.

The doctor kept me overnight after the operation. BestMed did athorized this overnight stay on 28/01/2026 when I made the hospital aware of the letter I received from BestMed [***/D***] and then the reference BestMed gave the case manager at hospital (Ticket: EEC047269A72A).

Now I'm receiving yet another bill of claims not being paid as BestMed told the service provider that the claim can't be processed because no athorization was given for the hopsital stay. Yet again BS. Ticket: EEC047269A72A

BestMed was truly a good medical aid up until 1 or 2 ago for me. Where their hospital plan was good for all of my other operations, when I needed to fix my leg and the rehabilitation thereof. This case is now completely a stressful, BS treatment, regardless of the member as a HUMAN. You should worry less about your marketing and fix your internal communication with the different departments. And yes I did send an email complaint to the correct department and yet - no answer.