Claim not Paid with hospital authorization!

Please do not consider this company as a Gap Cover!!. I was admitted to hospital on the 5/2/2019. While in hospital with hospital authorization from my medical aid I’ve seen the ophthalmologist on the 7/2/2019. I’ve received an email yesterday that my claim of the shortfall was rejected because it was out of hospital service. - by the way, this is weeks after I’ve submitted my documents for this claim! How is this possible that my medical aid covers it under hospitalization but not gap cover!!?? We’ve been clients for years and this is our first claim ever! I’m really dissatisfied and frustrated with this matter! I will definitely take this further!