Even with auth the medical aid does not pay PMB conditions

We treat patients in the hospital who are very ill. We have to constantly run around to get special auth for each of these patients before we can submit the claims for payments. The auths sometimes do not come through or only come through for one day resulting in us having to request again for the auth to be updated. Once this has been done the auth dept seems not to communicate with the paying department as the accounts constantly keep rejecting stating no auth when there is. REf 181217Q58fw2 and ref 191217Q594g1 and ref 290817Q3X1XR and ref 191217Q594BN. The physio has been retired for a month already and still she does not get paid for her hard work. Gems has appalling service and all I get are emails stating they have sent it to their keycare dept.