Poor management of the medical aids

My hospitalization claims was taken from my day to day, when i inquired i was told is a technical error of which they don't know when it would fixed. 3 months later nothing has been done. I pay the monthly premiums but still no day to day. My daughter is on the maternity programme each time the doctors claim GEMS reject the claim and say funds are exhausted instead of paying directly to maternity programme although the correct claim is used.