Disappointed with LA Health Discovery medical aid

I am so disappointed with this medical aid. I have been with this medical aid for almost 9 years now but they are not protecting me from silly doctors who sees our medical savings and want to take them all.

I went to this dentist MCLEOD AND POTGIETER INC, ERMELO DENTAL CARE Practice no. ***. What happened is that I first went to this dentist for wash and petch on my teeth. The doctor did a wash and told me to come back for a second appointment. I went again to his practice for a second appointment, he did what he did and told me to come again for a third appointment. After that second appointment I was in pain, I wanted to take out the tooth because I couldn't take the pain anymore.

I went to the doctor for the third time and told him to take out that tooth. This doctor told me that he can make a plan, he said he can do an implant after taking out my tooth. I ask if is it not going to be painful, he said no because they will give me injections. He asked me if I want to do the procedure in his practice or the hospital. I told him that I am afraid to go to hospital, then I asked him if in hospital is it going to be fine to the procedure or not. He said the problem with hospital is that they will charge me more than R5000. In my mind I was convinced that the procedure will be less in his practice than the hospital.

The doctor told me that they have done the authorisation with my medical aid LA Health, and the medical has agreed that they can proceed and they will pay the money. I was in pain during that time, couln't sleep for days because of that painful tooth. I agreed to do the implant same time after taking out my tooth.

Days after doing the implant, I received R7900 from my medical aid. I was so surprise why the medical aid send me that money. I immediately called my medical aid and ask what was that amount for. The medical aid told me that it was for the dentist, they told me that the doctor overcharged me over the normal rate, so they could not pay him directly and they decided to pay the amount to my account. I could not understand because to me the doctor spoke as if the implant was going to be less when I do it in his practice than going to the hospital. I called the doctor and spoke to the receptionist and ask why now I am being overcharged. The receptionist told me to come to the practice and pay the money deposited to my account by my medical aid. The receptionist also told me that she will ask the doctor about why I was being overcharged.

I went to the practice to pay the R7900 paid by my medical aid. The receptionist told me that they will speak to my medical to pay the outstanding money. I was so surprise that there is also another outstanding money, I asked the receptionist how much the doctor claimed from the medical and she said R11000. This made me so angry that I called the medical again to confirm if this was true and they said yes that is the reason they could not pay the dentist directly because the overcharged me.

This dentist doctor **** to me, convincing me that in hospital the implant was going to be more than R5000. If the doctor gave a pre-qoutation I was not going to accept that because that is too much money and I am not the only one who is in my medical aid. I have three dependants and I am the fourth person.

What makes me angry is that now they are abusing me everyday with calls and emails, telling me to pay the outstanding amount. Where would I get that R3900 because I do not have it and I did not agreed with him to pay that amount. The doctor told me that my medical aid agreed to pay the amount and now my medical aid is also refusing to pay that amount and they want me to pay it.

When I asked them why they did this procedure that requires such a lot of money and I was not told first about how much was it going to be, they said they saw that I have money on my medical saving and concluded that they can do this procedure.

I don't have the R3900 to pay that dentist and I am now being abused everyday to pay the money I do not have. My question now is why the medical agreed to pay for me when this doctor called them and did the autholrisation and now they are refusing to pay the amount?.

This is really bad from LA Health to allow doctors to conduct procedures and then after refuse to pay the money. I am really disappointed with LA Health discovery, I thought they are the one's who should protect us, but NO they allowing doctors to bully us.