Unpaid Claims

I feel like the only times I am helped by my medical aid for unpaid claims are when I complain like a "karen" on this website. So here we go again.... A. Maternity time 23 Nov 2020, routine check up. Pathology payment of R195 not done. Requested help from Discovery. 3 different answers. 1) specialist benefit was full. 2) late payment. 3) wrong ICD 10 code. B. Landed up in hospital 15 Jan 2021, acute kidney failure. Dr. Landi does the admission at Eugene Marais Hospital for the trauma unit. They do not pay them and I am still waiting for answers after several emails. They paid a Doctor for every day in hospital who only seen me every second or third day. Also a Doctor who was NOT my doctor for checking in. Not even examaning me. Then want to even discharge me while I am on treatment and in pain for acute kidney failure, wow. But they paid her claim. C) April 2021 went in for a follow up consultation. After getting a hernia repair and colonoscopy/gastroscopy in March 2021. I was asked to return April 2021. I received a bill of R1000 because there was no authorisation code. I was drugged up with meds when I left the doctor's rooms bit I was told by my fiancé it was a follow up scheduled, therefore I did not check if I need an authorisation code. This is a mistake on my part. However, I was told that I must resubmit and request for the followup to be back dated and please assist with a code. I was told this should not be a problem.

I have sent through everything a couple of times and not receiving assistance and answers. I am currently unemployed, I know its not their fault, however the doctors are threatening with legal action. Even though I am unemployed I make sure I pay medical every month. I am still in kidney failure because I requested assistance with a specialist which also no one can answer me on. Phone calls are cut and I am not answered on mail. Please advise. I will not lie this is a great medical aid and they have been wonderful. I know I ask a lot, however I am doing my best to contribute can I ask that my benefits be honored as stated in the documents.