Pre-authorization declined without

My father is on the Resolution Health Foundation option. His right shoulder started to pain severely and he went to see a Specialist, who said he had to be operated due to torn tendons. I forwarded the Specialist quote, Radiology report and specialist letter to the Pre-Authorization Department of Resolution. They declined the surgery and said it was not covered under the Foundation Option. They did not consider the specialist report and after several calls, could not provide me with a list of Prescribed Medical Benefits which are covered under the Foundation Option. <br> <br> On the website for the Council of Medical Schemes states that an emergency medical condition means the sudden and, at the time, unexpected onset of a health condition that requires immediate medical treatment and/or an operation. If the treatment is not available, the emergency could result in weakened bodily functions, serious and lasting damage to organs, limbs or other body parts, or even death. resolution is ignoring the fact that he requires urgent medical attention! <br> <br> My father is in severe pain, and cannot use his arm anymore due - what must we do?