No clarity and the consumer suffers

due to past experience i tried to make sure that i followed proper procedure. My mom required knee replacement surgery. we went to a specialist and he have me a quote and all the required procedure codes. i called in to discovery pre-authorisation and gave them all the codes and requested from the agent what amount they would cover for what i requested. they advised me that they would cover up to R37000.00. i was happy as the specialist quoted me less then that amount. after the procedure was completed Discovery only paid R19000.00 leaving me to cover the remaining R11000.00. i thought they may have made a mistake. i called in to query this and i was told that the doctor fees were more then the medical tariff they would cover. again i as the consumer was cheated. <br> how i as a laymen am suppose to understand what the specialist fee code is compared to a prosthesis fee is and break it down and understand what i am responsible for and what the medical aid is responsible for. Discovery is no different then the politicians that are cheating us consumers in this country .... super annoyed