Gems approved authorizations that are above scheme rate

I called my gynecologists today making an appointment then I was told that Gems only paid around R7000 for my C section last year 4th September 2020. The Doctor claimed around R27 000. Now I am suppose to pay R18 000.

I called Gems regarding this issue (call reference ***) and the person I talked to said the doctor said c section is elective and he never motivated as to why C section. That why Gems paid for normal delivery. On the other hand the doctor told me that I must do C section because I was delivering for the 3rd time now and I never had normal delivery in my life so I was high risk.

After that I got calls from Gems saying that no, the Doctor claimed above scheme rate and they paid 100% of the scheme rate. Now my two questions are why the 1st person in Gems told me that they paid small amount because C section was elective? Somebody please explain to me why can they pay normal deliver amount to C section claim. My second question is since Gems approved authorization, why now they say it above scheme rate . so what the purpose of sending authorization.

I really do not have that amount of R18 000 of which they failing to pay as well.

Gems people please to your job properly, I am not pleased at all.