Massmart Health Plan- Universal

I have been a member of the Massmart Health Plan (administered by Universal) for the last 4 years. My most recent experience with Universal has been very distasteful as I have had to endure one bad customer experience after another. On 2 May 2023 I had a severe allergic reaction (anaphylaxis) at work, called an ambulance and was taken to hospital. The guys from 082911 were excellent, they took pics of my medical aid card and contacted their control room to check which hospital would take me without me having to fork out co-payments and have madical aid issues. I was taken to Netcare Sunninghill where I was received in Casualty and admitted into High Care Unit. Universal took it upon themselves to decline my hospital authorisation (auth # ***) citing that 1. my condition was not serious (severe reaction with a swollen throat, tongue and struggling to breath) 2. I was not admitted into hospital (even though I stayed overnight). I have made numerous calls to the contact centre to try and resolve this issue since 6 May 2023. I was advised that the hospital provided the wrong ICD10 code, so I reached out the the Dr's rooms and the hospital to fix this. On 12 & 16 May 2023 I received confirmation from the doctor and the hospital that they have made contact with Universal to fix the coding issue, reassuring me that the matter would be resolved. On 16 May 2023 I called Universal to confirm that they have received the updated codes, and they could not confirm this at the time. Fast forward to 26 May 2023 and I get a letter confirming what the scheme has paid and declined (on old codes not new codes). the ambulance and the Casualty ward were paid, with 3 service providers left unpaid. On 1 June 2023 I start getting account statements from the doctor, the hospital and Lancet laboratories. On 2 June 2023 I called Universal again to query what is happening, and not to be surprised, after 25min calling from my cellphone I was sent from pillar to post with no customer service and no one taking ownership for resolving my query. As a member of the SCHEME for 4 years, I am now left with hospital bills amounting to +-R20k and swallowing the big pill of this distasteful customer experience. I would like to know the following from Universal Healthcare: 1. Will my matter be looked into with the dignity it deserves, and my service providers get payment, OR 2. Will you issue me with a letter of termination from the SCHEME, as I no longer wish to be part of this scheme, nor will I contribute to the SCHEME if it is run like a Pakistani ****a Shop

Looking forward to a favourable response.

Regards, Reinard Vaughan