Forced again to write on this medical aid's page because they cannot respond on any email

I am forced to write on Medihelp's Hello Peter yet again, I have not received any feedback to my emails sent to Medihelp (11 October and 18 October), no responses via my Medihelp "financial adviser" and no responses on my formal complaints lodged on Medihelp's website under "complaints and disputes". It seems like no one is able to respond at Medihelp which is frustrating, to say the least. As a customer who pays Medihelp a monthly fee, I do expect better.

To summarize the issue at hand, Medihelp you have rejected countless claims on a cancer patient who went in for surgery between 26-28 September (fully authorized and on your oncology program). You have partially paid the surgeon and anesthesiologist which is fine and understood (we are aware of this). However, you have failed to pay the below providers in full which goes against your own benefit rules and PMB benefits.

1. Pathcare - You have not paid Pathcare in full for blood tests that were drawn and taken IN the hospital. At the request of Pathcare additional tests had to be done (service date 29 September) due to positive histology results. This doesn't change the fact that the blood was taken during the hospital stay and that the reason was due to cancer being investigated further. If Medihelp doesn't understand this, you can discuss it with Pathcare to explain why further clinical pathology would be required when a HER-2 score is 1+ for a cancer patient. This isn't my job to do clinical investigations on behalf of Medihelp.

2. As part of breast cancer PMB treatment, sentinel lymph node biopsy is standard when doing breast cancer surgery. Medihelp has rejected the claims from the nuclear doctor who did the contrast prior to the surgery (this is standard, you cannot do sentinel lymph node biopsy without contrast) and said the member has no benefits. Medihelp, this cannot be possible that you do not know that sentinel lymph node biopsy is written in the PMB guidelines for breast cancer. You are well aware that the patient has breast cancer, she is in your oncology program!

3. You have not paid for codes 3629 and 0009 at all on the surgery. This makes zero sense. Code 3629 is for scans taken in the surgery room on breast lumps (again, the patient has breast cancer and is in hospital for breast surgery, the same surgery you approved!) and code 0009 is for the surgeon's assistant which you know you are also required to pay Medihelp.

I cannot fathom that I even need to be writing this out to you, a medical scheme that should understand and know basic coding and claims. This is your entire job to be able to understand claims and read invoices. Yet I have to spend hours doing all the work for Medihelp.

I hope this can finally get a response because nothing works. Not even lodging a formal complaint on your website works, so my only next option is the Council for Medical Schemes who I can show in great detail that the many emails I send to Medihelp goes unresponded to and that basic errors are made with claims costing us not only time, but money when doctors are demanding money from us for basic things.