PAYING FOR WHAT?

I am writing to formally raise a complaint regarding the processing of my recent claims as reflected in the attached statement. According to my understanding, I am on a Hospital Plan, which clearly states that all in-hospital treatments and related costs should be covered in full when using approved facilities and healthcare providers. However, I note with concern that certain amounts for services rendered at the hospital (Mediclinic Midstream) have not been paid, and are reflected as outstanding or unpaid. This is inconsistent with the benefits outlined in my Discovery Health Plan. These claims relate to hospital treatment for my child, and all services were received within a hospital setting. Therefore, I request a detailed explanation as to why: • These amounts were not covered in full, and • Why payment was not made directly to the healthcare provider as expected under a hospital plan. I kindly request that this matter be urgently reviewed and corrected, and that all outstanding amounts be settled in accordance with my plan benefits. Please provide a written response with a clear breakdown of the decision and confirm when payment will be processed. I trust that this matter will receive your urgent attention. Kind regards, Micayla Moll