Very disappointed Pregnant Medihelp Member.

Medihelp's new T&C regarding specialist visits and referrals are ridiculous. On Tuesday the 23rd of February I sent a mail to Medihelp, attached referral letter from the GP as well as the statement and invoice from the specialist. Please note that a call was made to enquiry on the process to follow in order to see the specialist, whereby advised to have a referral letter and thereafter submit a claim for the payment made at the time of the consultation. In this conversation, specialist on the network were also discussed and confirmed. A follow up call was made regarding the registration on healthprint for the maternity benefits, whereby assistance was provided. Another call was made to enquiry on how to go about submitting the claim for the specialist consultation that took place on the 18th February 2021. The advice received was that the referral was supposed to be submitted beforehand on the website and authorization was to be received via sms before the consultation in order to avoid a 35% co-payment. The reference for this conversation is N***. Please investigate the above matter as I am now unable to get assistance with submitting a claim for the specialist visit that took place on the 18th February. upon NOT getting any assistance from Medihelp since Tuesday, I have yet again called the call center. Each time receiving different advice. The representative was arrogant and didnt make an effort to "hear me out". Plain and simple just tells me that a co payment will apply. Please note according to the brochure received via email and i Quote: "Members will be required to obtain a referral from a network GP for specified disciplines of specialists, to optimise the coordination of appropriate care. Where referral to a specialist is obtained from a non-network GP, a 35% co-payment on the specialist's account will be applicable. This also applies to specialist services obtained without a GP referral." I have a referral from a NETWORK GP to a NETWORK SPECIALIST!!!! The representative advised that Medihelp and the NETWORK GP's have a contract and the GP was supposed to upload the referral before my appointment with the specialist. Please advice how I am being penalized as a third party that followed procedure. Surely this should be resolved between Medihelp and the Network GP! By the way, still awaiting manager assistance.