Prescribed minimum benefits claim process pain

Joined discovery medical aid recently and the very first time I needed them, I quickly realised that there seems to be something strange going on when you try to claim. I suffered a dislocation, have a bone semi-protruding from my sternum. Not an emergency but possibly serious. After visiting GP, got sent for sonar and xray all not coming up with a concrete diagnosis. A week later it didn't get better, so I went back to the GP and was referred to orthopaedic surgeon (not booked into the hospital, as outpatient). At this point I already drained my savings, so out of desperation I researched and came across prescribed minimum benefits that all medical aids must cover also if it's not an emergency - all dislocations and fractures are in the list. Armed with this info I called discovery prior to going to the specialist - got told there is a PMB form that must be completed by the medical professional, and if approved, it only covers claims from the date the doc signs it. This is issue number 1 - why did I have to push them for PMB related info? If I didn't, then there was no chance of me claiming anything as the form would be useless if I take it back to the specialist at a later date, as I had to get an MRI on the date of the first visit that I need to claim (also had no chance of claiming the xray and sonar now). This seems like a process designed to minimize changes of having to pay. I will also not have been informed of this PMB form and the date story from their side if I had not asked. So onwards - I had the specialist sign the form and he filled in the codes, confirmed its a dislocation/semi dislocation. Had to go for an MRI on the same day to confirm if there is anything else seriously wrong, as the initial radiologists suspected it could be a growth. I had to pay out of pocket. I submitted the signed PMB form the 14th June. The next week Discovery claims folks ask for all the radiology reports - issue number 2: is the PMB form signed by a specialist making the diagnosis not sufficient? I provided this. Today is the 2 July no feedback yet. No records on my profile on their site of this. When I contact the CallCentre I get told its escalated. What is going on here and why do I, the customer, feel like around every corner there seems to be another hurdle at Discovery health. The next step most probably will be a decline of my form because the radiologist wrote in their report possible dislocation, but the specialist did confirm it was the case. If this happens, I am off to the council of medical schemes.