****ty medial aid that robs patients

This shirt medical aid has done it again by short paying my PMB emergency claim not even half of the amount asked by Dr. So on the 10gh of October I was hospitalized due to emergency and had a procedure done while in hospital, the medical aid short paid my anesthetic claim not even by half of what the Dr asked for. The claim was R6422. 50 and amount outstanding is R3873. 02, so how do you explain this as this was PMB and needs to be paid in full. I was a principal member with this medical aid for 5 years and never misused benefits and now I am a dependent on my husbands medical aid and this is how they treat me. Now they coming up with stories that the ICD 10 code used is incorrect and not related to the actual treatment like really. All I want is for this claim to be paid. Also Medshield seems to have a problem with paying Anaesthetist, they did the exact same thing when I was giving birth and had to go up and down with a claim while caring for my newborn baby. Medshield is a **** of a medical aid and if you know what's good for you stay away from them. I was with Bonita and neve rhad such problems and will love to them next year not this mumbo jumbo of a medical aid. TRD 13/10/2022 PR *** AMT 6422.50 PT MP MASEMOLA