Complete and utter mess of claim refunds and PMB

Honestly I feel like the cost of Discovery is just not worth the amount of time and energy I put in to resolving issues and the refunds that I get. I have two more SIGNIFICANT issues that I am unable to get answers to.

1. My husband should have been approved for 15 PMB sessions with a psychologist. Having been notified of his approval, we later discovered that his sessions have been coming out of our medical savings instead. After numerous phone calls by our psychologist to investigate and then her further questioning why the original approval of the PMB was only for 1 - and then 3 - sessions, rather than the annual 15, she has been unable to get any further with the issue despite her request to have it reviewed being escalated to the necessary management level, again several times. (Reference number from last call ***). We are still awaiting a response on the issue.

2. My C-section delivery and emergency DNC surgery claim handling is a TOTAL CONFUSING MESS. I submitted the obstetricians invoice for both over two months ago and heard nothing back, receiving no notifications and nothing appeared on our claims online profile. The invoice was for R25,000 approximately. R20,000 for the C-section etc and R5000 for the emergency DNC. The emergency DNC rates she charged were the medical aid rates so that we would be covered in full. The C-section rates were higher as is usual so we would not get the full amount back, but our plan covers 200% of medical aid rates. Randomly weeks later I get a little over R10,000 in our bank account from Discovery. No record of what it was for can be found on our online profile or in claims response emails....we have NO IDEA what that money is for. If it is for the obstetrician bill we submitted then that is a serious problem because the R5000 surgery should have been covered in full which means of a R20,000 C-section bill Discovery only paid R5000 ...... which is ridiculous and not correct!

The amount of time I have spent explaining to call center operatives over..and over...and over again in relation to issues is just exhausting. We will be changing medical aids asap, I just cannot deal anymore.