Rejected claim for broken toe

<p>On the morning of 01/12/2016 (around 6am) I knocked my toe extremely hard against a chair and in the process broke my toe. I was rushed to MediClinic Durbanville by my boyfriend (I could not walk as my toe was very swollen and skew to the side of my foot), which upon arrival I was informed that due to my medical aid plan (Essential Saver Delta), any costs incurred at this hospital will not be covered.</p> <p> </p> <p>The lady then indicated that we should go to MediClinic Panorama (part of the Discovery Network). We then drove to MediClininc Panorama, where I was admitted via the Emergency Room and had X-rays taken of my foot (which I paid for). My foot was then strapped by the doctor and placed in a moonboot. </p> <p> </p> <p>However, I received a statement from MediClinic Panorama yesterday demanding payment at month end as it was rejected by Discovery due to "We have not paid the amount claimed, because the funds in your Medical Savings account are used up. Please pay the provider directly if you have not already done so."</p> <p> </p> <p>However, as stated on Discovery's website: "We cover the costs of a casualty visit if you are admitted to hospital from the casualty unit. We pay the costs from your Hospital Benefit, as long as we confirm your admission. Some casualties charge a facility fee, which we do not cover.</p> <p>If you go to a casualty or emergency room and you are not admitted to hospital, we pay the costs according to your health plan, unless it is an emergency or related to a Prescribed Minimum Benefit condition. Where treatment qualifies as a Prescribed Minimum Benefit, it will be paid for by the Scheme."</p> <p> </p> <p>So why are my costs incurred at MediClininc Panorama not paid for by discovery?</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p>