No payment, no reply to request for information

I pay Discovery Health a substantial R4420 a month, just for myself and my son.

In March this year, my son needed to have nasal cautery to stop severe & frequent nose bleeds. Following process, I called Discovery and got my pre auth number. The agent took the details and provided me with the number - no mention of any co payment or costs not being covered.

Fast forward to August, where I receive SMS's from the hospital saying I need to pay them R4407,14. I diligently log onto my Discovery profile and the initial screen actually says its been paid... to the provider. So I call the call centre, to be told by the agent that actually no, it hasn't been paid because its a Functional Nasal Procedure. The doctor and the anesthetist have been paid though - now I have to wonder where Discovery thinks we should have had the procedure done if not in a hospital?

I then asked the agent for a list of procedures that fall under the title of "Functional Nasal Procedures" - the agent didn't have this so had to request a special letter. No surprise really that the letter hasn't arrived - just another vague statement they can throw around so they don't have to pay claims?