What is the point of gap cover if it doesn't cover any gaps

<p>Claim XC119372</p> <p>I am overjoyed by the birth of another well born girl - Normal C-Section procedure, fully pre-authorized by Medical aid.</p> <p>Initially Medical aid makes a mistake and rejects the claim. After a quick phonecall, this is rectified and medical aid process these claims.</p> <p>GYNAE claims R9000 and medical aid only pays R3000</p> <p>ANAESTHETISTS claims R4000 and medical aid only pays R2000</p> <p>Both reasons for underpayment is code 28: Fees charged above medical aid rates.</p> <p> </p> <p>Xelus rejects these claims because they say the medical aid rejected the claims. After numerous attempts to tell them this is NOT TRUE ANYMORE, I fail to make any progress.</p>