Claim

Please look into my profile and give me answers that make sense, the call centre is no use your agents say different things all the time which is no help to the customer because they are the first point of contact, I am pregnant and went to see a Midwife that is part of your network at Genesis Maternity Clinic my medical aid is Essential Smart Plan well correct me if I'm mistake by saying they part if the network, for the first claim she charged me R500 for which Discovery paid back R451 which I had no problem with I mean it's only a difference of R49 which I than understand discover has its own rates far enough however for the next consultations which are Antenatal consultations she charges R400 per consultation and Discovery pays me back R106 I don't think any of this makes any sense in terms of the difference irrespective of the discovery rates have a look at the first claim amount and what I was paid and have a look at the follow up consultations I have been trying to get an explanation and I'm told it's the codes used firstly I don't work with codes and don't understand how codes work if there is something wrong with the codes as my medical aid why not laise with the service provider because she states that these are the codes she's been using since, If so kindly request any health practitioner that will charge me R100 and below for an Antenatal consultation and I will gladly switch to that specific person, The reason why I opted to have a medical aid was because I wanted to have a peaceful pregnancy with no worries but that's not the case , Midwife's saves the medical a lot of money but yet there are still problems I need this solved. Look into this and give me answers:

1. If R106 is your rate which is a huge difference compared to what was first paid out while I'm charged R400 refer me to another health practitioner for Antenatal that will charge me R100 and below 2. What is the processs when it comes to Midwife's there is a certain fee I need to pay her for the delivery of the baby the amount is R6500 which still saves the medical aid money a lot of it as it will be natural birth should there is no complications, what is Discovery's rate for the delivery fee when I claim the delivery codes are 88399+O80.0+Z37.0 Midwife's Details: Name: Daisy Kgokane Pr: ********** Tell: ********** ********** 3.The clinic I chose is Genesis will I be covered for my stay there? I got an authorization number but honestly with the service I've received thus far I'm not happy I want to double check everything and change if the need arise, I saw on the Authorization that I'm covered for 1 day is that an estimation or? The number is ********** 2 advise if there is any fee I will need to pay upfront 4. I need to see a backup gynecologist when I'm 36 weeks I need to know what are your rates which will be paid

Name of Gynecologist: Dr M Si***ane Pr: ********** Tell: ********** 800 Consultation code 0192 Z34.9 Ultrasound code 5107 Z34.9