********* non fulfillment of advertised benefits and no response regarding requested info

My mum needed to see an endocrinologist specifically to scan her thyroid and upon asking Discovery for a list of endocrinologists I was informed that there are non but to access a list via the Discovery app of " physicians" on the network. I wanted to make use of the " specialist" benefit where a member is entitled on Keycare to a specialist visit valued at R 4500 per annum. Upon checking I verified that she had the full use of the R 4500 at her disposal. Since there was no one except GPs on the network she visited the specialist and upon claiming thereafter received 33percent of her claim back. The breakdown of what was paid ie. Consultation fee and scan etc was paid from screening benefits etc and not from the advertised R 4500 which she had at her disposal. Since there were no specialists on the Discovery network you would think they would afford you the use of the R 4500. Upon enquiring I was told that yes there are no specialists on the network but I am to find a physician ( actually a general practitioner) who would have been able to serve as a highly specialized endocrinologist to scan her thyroid for nodules. I made calls and no go was able to perform this function. So why is there a " specialist benefit" where you do not have access to a specialist nor the R 4500. I was told that it is not Discoveries fault that specialists do not agree to the menial R700 they are willing to pay as a consult. I mean which highly specialized specialist would agree to this amount offered anyway? So there is no actual way to make use of this so called " specialist " benefit seeing as there are non on Discoveries network. Why not increase what you offer specialists so members can make use of this benefit which is actually a farce? If you are advertising that the benefit offers R 4500 pa then members should be able to make use of it regardless if a specialist is on the network or not. Since my mum has a follow up biopsy to be done by the specialist falling under a new yearly period I asked a consultant to let me know how Discovery will cover the claim of the follow up appointment. She asked for a detailed quote for the fine needle aspiration to be sent through which I did. All I want to know is how will the claim be paid ie. How much? And will it be done via the so called non existant " specialist benefit " again meaning the member does not benefit only Discovery. Surely thus info should be provided upon request so members can budget etc. Discoveries ambiguous response was that a referral be through for the follow up from the gp and IF approved an authorisation number will be sent through. My question was totally avoided. The question being how much will we receive once claim has been submitted.This institution will do whatever it possible to not pay claims or pay reimburse the lowest amount possible never mind the members who hardly make use of the medical aid and diligently pay premiums and huge increases without questions. The ambiguity surrounding the " specialists" actually being physicians / gps etc is ridiculous but surely works to Discoveries benefit. Please note that specialists are NOT general practitioners and the latter cannot serve as such. This is regarding the health of your members that you are messing with. Would you at Discovery send a member of your family to a GP to diagnose the possibility of cancer? Wake up Discovery and re- evaluate your ethical standards and also your customer service. The fact that you hide in order to with hold requested information portrays your institution to be that of a lowly *****ed one. I would like the information to be made available. The quotation has been sent through multiple times and I have logged various complaints but have received no response. You really should consider your ambiguous wording regarding your available benefits as well which works perfectly in duping potential future members.