Claim not paid

Good day.

I recently had a dental procedure done at a hospital in Port Elizabeth. This specific procedure had to be done in hospital at an service provider of my medical aid being on netcare medical aid I followed the requirements, reveived autherization for the procedure in hospital/ theatre on the 14 December 2018. 11 January I receive an account from the hospital stating I owe them a large amount of money R12,602.53 of which my medical aid only paid R2,214.85 I owe R10,387.68 as short paid by the medical aid. I phoned my medical scheme on the 11 January regarding my concern and as to why I owe such a large amount to the company the first person I spoke to said that they would log this concern of mine and get back to me in a week. I phoned back the 18 , 25 , 4, 5 January no progress they are still waiting for an reply or they will contact me back which NEVER happens. On the 28 January I received a first private notice to settle my account , I explained to the company that I have queried this account with medical aid and waiting on a reply the company said they will note it on the system as to why there is a delay in payment. Today the 7 January I have phoned again speaking now to the 4th different person who has "taken over" or "handling" this concern. Each time I have to explain the situation from the beggining and receive the same response we have sent in a request and we "WILL" contact you back which never happens. The very first guy who I spoke to X2 on different calls by requesting to speak to him as he knows the situation is either not available when I contact or he will contact back. I feel that this debt has been added to my name incorrectly and unfairly as I followed the schemes requirements by going to a designated service provider to avoid any co payments or accounts. This procedure is an procedure which had to be done in hospital in theatre. Netcare medical scheme does not inform you of these things on phoning for autherization which is a lack of service and incorrect information provided leaving a member with debt and financial strain. I do not have a contract phone whereby I can call whenever I want to, I buy prepaid airtime each time to phone this scheme this has occured on numerous occasions and I am dealing with unnecessary stress. I hope to receive a reply regarding this matter as it is unacceptable paying towards a medical aid who cannot even settle a account of R10,387.68.

Regards K.Rautenbach