Discovery: medical aid or a ****

Over the years I have learned that discovery follows a certain way of things to pay claims so if I don't understand something I call and ask. I was told for day to day extender I had to use a nurse first and a certain system for my claims to be approved. I called to ask where I could go for a nurse and was given Medicare douglasdale. I went, the nurse consultation and subsequent doctor consultation were not paid because I had some savings in my account. Fair enough I didn't know you had to be on zero, nill, null balance. I went again now the doctor is said to not be on the network 🙆♀️. Please note the nurse consultation is not paid either by discovery. At this rate Discovery has a process that they enforce but also have no control over who follows this process on the doctor end. So now I'm curious is this really the issue or a subtle way to ensure they don't pay claims. At this point the benefit for being with discovery is non existent and after 6yrs I'm tired and really have no business being loyal to such bad policy management.