Unfair and day light *******

SHOCKING SHOCKING SHOCKING to say the least!! I went for tests at Lancet Kloof hospital in September. I am on Medihelp Necesse and I went there knowing very well what the scheme rules require for payment. A Network doctor must complete the Medihelp Necesse Pathology request form and it must be given in at Lancet, if the codes of tests required are on there, the scheme will pay. If tests which aren't on that form at requested by the doctor, then I will be liable. I went there with the form, the doctor required 2 additional tests which weren't on the form but he wrote the required test on the form and I FILLED IN A SEPARATE FORM FOR THESE AND I PAID FOR THOSE UPFRONT because I knew it would not be covered. After some time I started getting contacted by lancet for outstanding monies. I called and spoke to the accounts receivable department. They sent me the tests and I checked my medical aid statement. Lancet put through tests 4652 and 4653 which weren't on the Medihelp Necesse pathology form and were not requested by the doctor. I told him to immediately investigate and he explained something about reflex tests which are done if further testing is required. My argument around this is, should I not have been contacted in this case? Should I have not been asked if they can do further tests that will be for my account? I am a fair person, if the medical aid did not pay because of lack of funds, I would have been happy to cover these costs. If they contacted me and said further tests are required which the scheme wont pay, I would have made a decision there based on that. But I went there knowing the scheme rules and I don't do something unless I know there wont be costs over and above later. I have spoken to several people in the call centre, accounts receivable and even a supervisor (apparently) since and they keep insisting the doctor did sign for these tests to be done. He did not mark 4652 and 4653, therefore did not request these tests. The all argue it is on there because he marked a urine test- HOW DOES THIS ARGUEMENT MAKE SENSE?? the codes are there for a reason. The medical aid paid everything with codes that were on that form, even tests which the doctor did not request but you took the liberty of charging for anyway. ( I will be reporting this to Medihelp too - codes 3797,3928,3867,4188,3893) I have had a fight with many of your staff and all insisting I have received the forms which shows the doctor did request. I told them to send to me the forms I got don't show any proof that the doctor approved those tests. If I am not seeing it they must please send it again and circle it in red, which no one has done. I feel this is unfair practice. I WANT A CREDIT FOR THE TOTAL OF R424.50 which you are claiming I owe. I am ready to take this to the health Ombud to be investigated.