Profmed: Exhausting non-service!

I have been a member since Jan 2022. The consultant who signed us up keeps telling me that she is so sorry for the poor service and that this has never happened to her before which I find really hard to believe. How on Earth can service be so bad all the time. Every single claim I send through has to be followed up at least 5 times before it is processed and paid, if it is processed properly. I have been fighting a dental claim to be authorised for months, and could not wait any longer and went and did the work, for them to reject the claim stating it had not been authorised! When we signed up I told them that my son had braces and it is OBVIOUS that he will need a retainer when the braces come off! But they keep rejecting the claim because they do not read their emails properly. The same for medication that I have been asking them to process and pay FOR MONTHS!, then they need this, then they need that, then they need something else. Is there not a list they can send with all the things they want or do they stop looking after the first line that had a problem and just shrug their shoulders and then do it again the next email etc. I do not know how much longer I can continue with this type of non-existent service, but hear I am stuck with this awful service for a year! Yet every time I complain I get a call to apologize profusely for the poor service. STOP APOLOGIZING and FIX IT! They have paid a claim partially and sent a statement with an amount they are due to pay me, and then pay short, so I can't even trust that they are going to pay the right amount out. I am tired of fighting for things to be done. They should be paying me for doing their work. The medical aid is not cheap and the service they are providing is not worth the large sum we pay on a monthly basis. Why should I be the one to tell them it should come out of PMB or come out of savings or come out of PPS, is it not automatic that one would ASSUME that if it does not qualify for PMB that it would automatically be moved to day-to-day savings? Next stop is OMBUDSMAN this cannot continue like this