Terrible Service

<p>In 2012 my wife gave birth and the medical aid covered the full amount of the doctors’ fees. This year my wife gave birth again using the same doctor, doing the same procedure as in 2012 but this time the medical aid covered less than a third of the cost. When I queried this I was first told that it was covered according to scheme rates. After I told the agent that the full amount was paid in 2012 for the same procedure it was sent away to be reviewed. After not hearing from the medical aid for a few weeks I queried this again and this time I was told that there was no service associated with the modifier used by the doctor. After this was corrected by the doctor, and payment was still not made I queried it again and this time I told that the doctor needs to provide a paper trail. The paper trail was then sent thru and still no payment. I spoke an agent again today and it looks like we back first excuse about scheme rate, and I was too exhausted to explain the whole scenario to him. This case has been going on for a few months now and I am disgusted with the service I have been receiving from the medical aid. I get a different reason why payment cannot be made everytime I called, and even when I provided everything they asked for the payment still was not made I pay the medical aid to see to my medical needs yet I have to call the doctor and explain modifiers and medical terms I know nothing about. This is poor service and if the matter is not resolved soon I will definitely be changing medical aids.</p> <p> </p>