Fedhealth wiggles out of paying - again!

Another warning, in case anybody out there is considering this medical aid. I think they have a whole department thinking up ways to get out of paying claims! This story is like a bad soap opera. Early in April, almost a month ago, I had a serious and very necessary dental procedure. I had a cyst in the bone of my upper jaw that had to be removed. Note, Fedhealth, it was not a vanity project. It was an infection very close to my sinuses and my brain! (Not that you care.) I paid the invoice and then submitted to Fedhealth. Of course, they pay the low cost items, but reject the two most expensive line items, with the reason: Procedure code does not exist. Not any explanation or any information about what the correct codes must be. So I send the invoice back to my dentist. He is just as puzzled as I am, and starts phoning around. At last he gets two new codes. I submit again, with an explanatory email. I am ignored, which is standard procedure for Fedhealth's Claims Department if anything is not straightforward. I write an email to Optivest and ask for help. A very irritating man phones me with a whole long story. Basically, one of the codes is not covered under my plan, so I assume I should have done without the filling up of my upper jaw after the removal, only to have a more serious operation later down the line, aka Fedhealth logic. The other code is apparently still incorrect. I sigh and ask (according to me) some logical questions. "Why don't you just say 'Not covered' instead of 'Code does not exist?' It would have saved a lot of time." His answer? "But the code does not exist for your plan." (I don't know whether I should laugh or cry.) I try again: "Can you just give me the correct second code please?" His answer? "Please ask your dentist (who is fully booked 6 days a week) to phone so-and-so call centre." (I immediately feel my blood pressure shoot up.) Really? Have you all gone mad? If the people at Fedhealth are sitting around with have time and energy to waste, please note that some of us are actually working very hard and do not have time for your games. This is yet another tactic to make it as difficult as possible to get a claim through, especially if it is for a large amount. I am too old to change to another medical aid now, but for the young people out there. Stay away from Fedhealth. You are going to be very sorry if you decide to go with them. There are some much better options available.