The **** in the scheme

Has per my Medical plan while in hospital it was suppose to be fully covered/unlimited in-hospital cover, I had a procedure/operation done last week and luckily I was driven to the hospital that is part of the plan that I'm on and I expected no issue with the medical aid paying the full bill. Firstly the procedure had to be done by a specialist, Discovery declined to pay the full amount for the procedure which was just of R21k I had to pay R14k, the anesthesiologist bill might be declined too as if I'm suppose to have the op without one, I called Discovery to resolve the doctors payment but the lady on the phone had no solution for me. She could only read what was in front of her. She mentioned that the doctor is not on their list of the preferred hospitals, I asked if there was another specialist in the same hospital that she can refer me to but she went silent. I appreciate the treatment, care and have respect for the work the nurses do but that's not the primary reason patients go to the hospital, we go to this private hospitals to see specialists and we expect them to be fully paid by our medical aid, specially if it the hospital that one is covered for by the "scheme". So if I went to the hospital where the doctor on my health plan or benefit/ Discovery list of doctors is on but not in the hospital that's not part of my health plan, then I would be paying for the hospital bed? Has a patient I was not in a state to take myself where ever it was convenient and suitable for the criteria of Discovery's scheme, knowing how much is contributed towards the scheme, it is frustrating dealing with this logistical complexities from Discovery, I have never had any other medical aid except with Discovery. This experience really opens up the **** in the scheme.