Legitimate claim rejected and yet authorisation was granted.

In early March I was admitted at Arwyp Hospital emergency for a swollen knee. After the Orthopeadic Surgeon check-up (i.e. MRI ). it was discovered that my knee had infection and my bone also needed to be fixed. I underwent the first surgery where they drained the swollen knee. I was discharged and had to return for another surgery of the knee bones of which I did in late March. Bestmed only paid for the first surgery and are now declining the pay for the second surgery which amounts to over R30 000-00. Through Arwyp, Bestmed was furnished with the Radiology Report to indicate that I had to undergo another surgery but still they could not consider the recommendation.

The plan that i'm in is Pace 1 and it has a limit of R81 700.00 for internal prosthesis and I have only utilised R14674-00 for the first surgery. currently i have a R67 026-00 remaining in my plan and still they don't want to pay.

I'm currently not yet fully healed from the severe surgeries I had and now Bestmed wants to stress me.