PATHETIC IS A COMPLIMENT

My mom has to be admitted to hospital for pain treatment. They did scans & x rays & she had to have a back surgery (decompression and fusion) we got pre-approval beforehand. A few codes were rejected and upon enquiring the reason for the rejection of the codes, were because they were include in other already approved codes. Myself, my mom and the Dr phoned to confirm this. We proceeded with the surgery. After the Dr submitted his claim (R136k) they refused to pay & only paid R36k to my mom to settle the Dr bill. We had to cover the rest. I went through their process of complaining and each time they had a different story. We then get a call from the Debtors department of medihelp informing us that my mom owes them money, because they made the incorrect payment to my mom. They were only suppose to pay R26k for the surgery and not R36k. That was their error, but legal action will be taken against us, because we owe them money. ABSURD! When enquiring about this, they cannot provide me with the correct amount, then they say R32k was suppose to be paid to my mom, then it’s R26k and then it’s R35k. It keeps changing, but they cannot provide me with their calculations and proof when asked to do so. I spoke to a manager who said she will follow up, however I never got a response to what her investigation resulted in. I laid a complaint with the medical scheme’s council and they had ample time to report back to the council, however they asked for an extension. THEN and I kid you not, they send an email to the Dr and my mom, requesting the Dr to change and amend his codes and account. We were left in over R100k debt due to them. They approved a surgery that was needed & we went through with it believing they would pay because they approved it. But instead all they did as misrepresented the situation. Each time I spoke to an agent, it was a new and different agent and I had to explain myself from the beginning again. They are PATHETIC and unprofessional. We suspect money laundering and ***** from medihelp, because if an audit had to be done on our accounts with them alone, it would be a mess.