PMB condition -long drawn out processes

Ive been a member with Discovery since 2014 and i have barely used my medical aid until recently having to go to casualty under emergency circumstances with kidney stones. I have unfortunately just cancelled due to their excessive claims process.

On 11 May, I went to casualty under emergency circumstances due to a PMB condition. After initially rejecting most of my claims without even enquiring with me, even though the doctors used a PMB code on the invoice, discovery finally approved my claims ONLY round about 26 May, after i was told to submit a PMB. application where the doctor had to motivate for the PMB condition, which i completed.

One final bill from the exact same date that i went to casualty remains outstanding and i was told yesterday that i need to AGAIN get the doctor’s motivation for this claim to be paid. Why do i again need to get the same motivation for what is (1) a already confirmed PMB condition and (2) was an emergency situation?

What is more, i needed to do a follow up with the doctors after a few days of being released from casualty, but i could not do this until discovery confirmed approval of my PMB condition. From 11 May till 26 May to finally get approval for my claims - i had to wait all that time and did not get to do my follow ups because a follow up would be another process of authorisation!

Being a long standing member I was very disappointed. Also dont feel like i got solid direction on how to deal with my claims from Discovery call centre agents. I ended up actually calling the hospital i went to, who were able to give me much better direction on what i needed to do.