PMB Claims unpaid - Terrible service for years

I am frustrated with how Medscheme processes Boncap claims. It is a constant battle and all I ask is that you do your job correctly by paying valid claims as per the law. You get your premium on time and yet my admin time is spent on email Boncap , MEDSCHEME, PHA who now does pathology claims, and lawyers looking for money from a state pensioner, who takes all her pension money as they do cover half of the medication. My mom fell and broke her hip in July 2023 I took her to a network hospital Melomed Gatesville, where she was treated by the orthopedic on call, Bonitas short-paid and said Non network doctor, I rep**** you cant choose a doctor for an emergency, now naturally after the hip replacement this same doctor has to provide in hospital care and treatment, this is a PMB so the claim should be paid at a cost which was not done. After the operation my mom health took a turn for the worst and was a step away from dying, her organs started to give in and there were medical complications, my mom was placed on a ventilator and the hospital required to use creams to prevent bedsores, BONITAS would rather a patient get a bedsore than pay for the creams used R400 unpaid on Melomed ward stock for Melomed GatesvilleDos:01/09/2023 DOS; 07/09/2023Cavalon and secure used after hip replacement. Your medical advisor received a clinical letter of Mot from the Orthopedic surgeon as to why she needed additional Re- hab - and it was approved to be treated at Faircape where you received clinical reports. Now Fair cape was short paid and the PR72 while the patient was at Faircape was also not paid saying only PMB - What more do you need, the patient fell, and required treatment to help her walk after the hip replacement. The patient had internal bleeding and was taken off from warfarin and then when she went to step down put it back on it. This requires testing 3*** to be done, level 1.1 now it's a weekly struggle to get BONITAS to pay this from the treatment plan. Look at my complaints over this year and it's the same story over and over. I am still struggling for you to pay an R500 positive COVID test, this is a W.H.O benefit and a PMB and still I am struggling. Maybe the council of the medical scheme would be more helpful if I lodged a complaint of incompetence of this medical aid. I am not asking for invalid claims to be paid. PMB level of care. Please can someone look at all clams for my mom from July to date, I am tired of emailing and getting no response or a standard response, No benefit as it is not a PMB the lab for the warfarin test are using the correct ICD10 CODE.