Short payment not acceptable !!!

<p>Really disappointed with the response received from Discovery regarding the short payment on my recent claim # ********** 8 </p> <p>Firstly it was requested I obtain a letter from the Doctors room stating my sons admission was an emergency which was provided ,it was declined based on the fact that I voluntarily used the Doctor since 2015. My baby was sick it was during office hours so I followed the norm , called the Paediatricians room got an appointment and took my baby in , after the Doctor examined my baby he advised how sick he was and that he would have to be admitted immediately , I am not sure what Discoveries definition of EMERGENCY means but to me this clearly was an EMERGENCY, was I expected to drive around looking for a Doctor that fell within the scheme rate and risk my babies health or get him treated immediately??? </p> <p> </p> <p>I fully understand what rates etc are covered according to my medical aid plan however I refuse to accept the short payment on this claim due to the fact that a month earlier my son was also admitted and I followed the same procedure and used the same Paediatrician and the claim was paid in full. There were no questions asked so why is it an issue this time ?? In fact his admission this time was more serious as he was in Paeds ICU for five days . Discovery advised the reason was because the ICD code used was not classified as an emergency so why can’t this be rectified when there is proof from the Doctor clearly stating it was . Discovery are looking for every excuse in the book to short pay which is not acceptable.</p> <p> </p>