struggling with my medical aid

Good day, on 06/02/2020 I had a battle with regarding a procedure that to be done on my wifes shoulder which after sonars and xrays showed that 3 muscles were torn off Boncap authorised after letters of recommendation from the specialist eventualy gave us the go ahead on authorisation number ***0 After the operation she had to wear a sling for 6 weeks which she did After the sling was removed and some physio therapy she noticed that something was wrong because she had severe pain The specialist ordered more xrays and noticed that some of the *****s came loose which caused the pain and needed surgery to rectify the problem We then app**** for another authorisation from boncap which they denied and said she is not a pmb case and the tipe of formulary (arthroskopie) is again not on the formulary and said it must be done on open surgery Again they said they needed a recommendation letter from the specialist which was then submitted to them and again they denied the authorisation with no apparent reason What I really want to know why because on the same no (***0) the second operation is exactly the same If this operation is not done my wife stand a chance to eventually loose the use of her arm and she must always live in pain On the second application we were given a referance no of BON***7 I hope for my wifes sake that this matter can be sorted out Regards Mr Leon Potgieter Tel no *** My member no ***