Bonitas Medical Fund – Page 4

Patient (REF [protected]- [protected]) was in hospital 01/04/2018-06/04/2018 yet bonitas paid two Doctors with the Day-to-day-benefits funds instead of hospitalisation for 03-06/04/2018. All the required information was sent to bonitas but even now in August this matter is not yet resolved. I have to pay the specialists and buy medications cash all because of the negligence of Bonitas. This is totally unacceptable!

I want all the funds used to pay these two doctors to be paid back to the day-to-day-benefits funds.

Claim submitted on the 28/06/2018

9 Days later after submitting the claim, i called to find out whether or not they had received my claim, I was then told that claim would be resolved within 7-14 working days. On the 14th day i called again there i was told my claim had been rejected because i did not submit a referral letter from the Dr., On the same day i then emailed the outstanding Referral letter. Today being the 24/07/2018, I called yet again because there was no consistent communication from them. I was now told that i need to wait another couple of days.

I am extremely disgusted with the level of unprofessional ism i am receiving from them. They do not bother to communicate anything with me being the client, instead i am the one having to follow them around, calling or emailing just to know what the hold up may be but even then i can never be told the correct and precises information about my claim. This has now also become an inconvenience to my financials because i know have to continuously fit the bill that my medical-aid had to pay...

REF:[protected]_[protected]]
I have a debit order dispute that I have submitted forms for on the 27 march2018 been calling to make a follow up no luck I understand that the turn around time is 30 working days, NOW I'm getting another email saying that I need to send new debit order dispute forms as they can only assist me once that is done is that even fair though? This is very unprofessional I cannot do this back and fourth with you guys because it means if I send new forms its now going to be another 30 working days that I have to wait for which means 60 working days. i asked to get a reply on the 27 of April regarding my dispute as I send other forms again. Let me know if this will be possible for you to reverse my money that was deducted or I should change the bank as the service is very poor. You have such incompetent consultants my money you need to make it happen that me as the client I am happy because right now I'm very much unhappy with your service . I did not get an reply from you guys kindly get back to me

I have recently been retrenched. Mr Shane Moses came to our place of employment (Karbochem Newcastle)a month ago. All the Bonitas members filled in the forms to either discontinue membership or to continue in a private capacity. I elected to continue in a private capacity. My membership has subsequently been terminated. Mr Moses is unable to answer as to why the documentation was not sent directly to you and he seems to be unable to find the necessary forms that were submitted. Last week my grand daughter was admitted to hospital with swine flu. If these accounts have been rejected by Bonitas because our membership was terminated then I will hold Mr Moses personally responsible for the medical bills. I am most dissatisfied with your broker's service and wish to lodge a formal complaint. I have subsequently resubmitted the documentation directly to Bonitas and am hoping this matter will be resolved immediately.
Mr D A Headley [protected]

On 14 May 2018 I saw a GP, as my left airways felt permanently blocked and due to this I have pain in the left side of my face. The GP was unable to diagnose me and therefore referred me to an ENT specialist (Referral Number [protected]), for further investigation. I booked my visit to the ENT Specialist for 24 May 2018, as the referral was valid for 2 months.

On 24 May 2018 ENT Specialist sent me for a CT Scan (which I paid myself) and he found that I had a Deviated Septum to the left. The ENT Specialist then booked surgery for Monday 28 May 2018. On the same day, after my appointment I called the medical aid to apply for authorization which was immediately captured.

On Friday 25 May I received an email from the medical aid, declining the authorization due to a possible "non disclosure of a pre-existing condition" and they requested a clinical report from the treating doctor, which the doctor sent back to them, including a copy of the CT scan report.

On 28 May 2018 (surgery scheduled date) I was called by Ilhaam Jakoet at the pre-authorization department, informing me that the authorization has again been declined, and this time due to a 3 month waiting period imposed. I ask her if the doctor's clinical report was received, and she couldn't confirm and asked me to send it to her direct email address and that she would submit it back to the underwriters.

On 29 May 2018 Ilhaam calls again and tells me that the authorization came back from the underwriters, once again been declined due to 3 month waiting period. I queried the waiting period as I did not have a waiting period when I joined nor does it stipulate it on my membership certificate. (not knowing that the waiting period was imposed only on 28 May 2018). Ilhaam, very unprofessional tells me that even though I pay medical every month, if I should get into an accident, I wont be covered. By this time I am furious with the response. She sends me an email with the authorization being declined and the reason is…"please contact our contact centre for help with cancelling your membership". UNPROFESSIONAL to say the least.

I then contacted Bonitas Connect where I am told by the agent that the real reason for the auth being declined is that the GP and ENT specialist diagnosed me with 2 different conditions which coincide with one another and because I used nasal decongestants. What Bonitas fail to see is that the GP referred me to the ENT specialist to be diagnosed (they provided the GP with a specialist referral number). So how could this have been a preexisting condition if teh GP never treated me for any nasal conditions neither prescribed medication. The nasal decongestants I use is to try and open the airways, obviously because I am not a doctor and cannot diagnose myself but I can self medicate myself.

My surgery has since been rescheduled for today 31 May 2018 and admission time is 8.30am and I am still fighting with Bonitas and their incompetent staff, who struggles to understand logic.

On 30 May 2018 I called their call centre once again and insisted to speak to their teamleader. They put me through a guy called Zander who happens to be the team leader and he asks me to email him directly and I send through all documents and a written report. Hours later I call and he conveniently is not around for hours to answer my call. When I eventually spoke to another agent I was informed that the team leader received the email but not the attachments, which was an utter lie as both emails sent had all docs attached. Later the afternoon I called the call centre again requesting to speak to the team leader who was very abrupt and lied to me over and over trying to cover up his laziness and unprofessionalism.

I am utterly disgusted with the service Bonitas have rendered over this last few days. I was on Bonitas medical aid for 7 years and cannot understand how the level of their service has dropped to zero and treating people as if they are doing them a favour. People pay 1000s for medical aid and this is the kind of service we are being rendered.

I request a full investigation into the matter and need urgent feedback.

I have a 6 year old daughter who is physically disabled. She was diagnosed with Hydrocephalus at 5 month due to brain damage caused by CFS she was also diagnosed with Cerebellum Palsy and Epilepsy. In 2016 my shortfall for Bonitas was plus 60 000 on which some of the claims it's not even clear why they were not paid. This short fall is for one person for all the operations that were needed to save her life. Last year Bonita's did not pay for her splints as much as they are still on PMB approved list but they don't pay without a valid reason. Each time I call a new consultants is investigating and escalates the query but there is no payment. The service date for this claim was the 15/06/2017. Another query where not I've been summoned for non payment and the medical aid is not pay is for anesthetic for MRI done in hospital on the 9/05/2017 in hospital. Each consultant will perform some short analysis and conclude with a different resolution mostly does not even make sense. Kindly assist to resolve this issue we are paying but we don't get the help we deserve. Membership number [protected].

I have been a member of Bonitas Medical Aid for 5 years but this year will definitely be the last year. Your service had deteriorated so and nowadays you are to scared even to go to the hospital for a procedure. Nothing in-hospital gets paid except the hospital self. I am still sitting with all the pathology accounts, physiotherapist accounts (all of it been handed over). Was send numerous time to the claims department and still not paid.

To whom it may concern 

I'm very much disappointed with the level of service the Bonitas and thier employees have given me. 

I requested for a hospital authorisation on Thursday last week the 22/03/2018 for a procedure that will be tomorrow 27/03/2018 at 7h30am. I was sent from pillar to post and no one was coming back to me telling me if it is approved or declined. I was request to send a photo of my scar which was sent at 12h00pm as per the email. I was told it was escalated to medical assessors. I am sure everyone dealing with this request knew that the procedure is at 7h30am the 27th of March and I was promised that I would have my response before the end of business. After doing several follow ups I still had not have my response and when I called again at just before 5pm I spoke to an agent by the name of Katlego who was supposedly escalating the matter to the supervisor, who was supposedly getting in touch with the medical assessors responsible for my request. At the exactly 17H00pm the agent that I was dealing with cut the call on me and when I called back I was met by an answering machine. I still have not received any feedback for a procedure that is at 7h30 tomorrow. 

It is rather disappointing to receive such appalling service and very disgusting for a lack of a better word. 

Not only was I the only one doing the following up my husband too was met with poor service and was also sent from pillar to post. At 17h11 he received an email stating that the medical assessors didn't not receive the picture which was sent by me to [protected]@bonitas.co.za and a gentleman that also assisted me by the name of [protected]@medscheme.co.za also request that I send it to him which he forwarded to [protected]@medscheme.co.za but conveniently the email was not received. Maybe this was done intentionally to inconvenience me so that by the time I need to do the procedure they can safely say that they did not approve the procedure. Is this how you deal with your loyal clients? You show total disregard and no sense of urgency. This is by far the worst treatment and service a client should receive. You took me and my husband for a ride. 

I have been with bonitas for the last 2 years, option BonCap. My company pays for my Medical Aid in full. Last month I needed my son added on my policy, I got the necessary documents from my company's Bonitas represented filled it in and attached all relevant documentation (my son's birth certificate). I was told every thing was in order and that I had a 3 month waiting period.
When the first debit upon adding my son on did not come out of my account I immediately approached the a Bonitas represented assigned to my company as I need my son covered ASAP, and he advised that the documents he had given me were the wrong documents as it did not have the year which is 2018 on the top right hand corner of the documents as it's a new year, he advised me that the Membership Department rejected the documents, I advised him that the Membership Department should have notified me ASAP so we could get the correct documents filled out and not have waited until I noticed that no debit has come off to query this.

I think this is unprofessional as I believe this could have been pushed through or sorted out before the end of February 2018, secondly I should have been notified ASAP from the Membership Department or Bonitas via email or phone that I need the correct documents filled out and submitted and I would have done so ASAP. This is unexcitable and I request this matter be addressed and sorted out urgently.

I now request that my son be added on to my medical aid backdate as from February 2018 as this was the fault of Bonitas or the Membership Department failure to do so will result in my going to the Council of Medical Schemes [protected]@medicalschemes.com. [protected] and Hello Peter.

I was on unpaid maternity leave and called bonitas to find out the outstanding balance so that I can pay in cashthe consultant told me there is nothing outstanding. I get back to work there is 3700 outstanding and plus I must pay 2000 for monthly contributions I sent emails and been calling several times no one can assist me and give solutions I sent my baby birth certificate few weeks after he was born they didn't receive it sent again they only registered him yesterday my baby is almost 4 months this was the worst experience ever even commed that was liquidated was much better a pleasure I have outstanding medical bills so I ask now whose fault is it as I did my part by calling wanting to payno one can help for their mistakes

I was admitted to hospital on 1 November 2017 for major surgery med.aid number [protected]. Main member Donaveve Mangers. which included a total abdominal hysterectomy including ovaries and cervix as well as bowel and rectum resection due to endometriosis.
Bonitas refuse to pay for the specialist surgeon that assisted with the operation. Rhis specialust wasnt just standing there looking all pretty he was there as the surgery performed on me was very risky and his role was to foresee that I get out of theatre alive. We pay exorbitant amounts for obtaining the best care possible and you just go and deny payment. Where am I suppose to scratch out R5800 from. This is unacceptable. If it was a normal assistant would you have paid? I had a bowel resection as well as total abdominal hysterectomy which was a necessity for a specialist to be around. Can someone please look into this and get back to me.

i have made numerous claims and follow ups on claims after my daughter and her mother were admitted for an emergency c-section when she was born.

Bonitas has has not had the decency to respond to it, not even rejecting it.

the hospital has also made numerous inquiries, the only time that get anything is when I call Bonitas and they say they are looking into it and awaiting documentation from the hospital and doctors.

Please advise the way forward for this matter.

this is utterly disgusting service to say the least

Bonitas... Oh Bonitas... I dont even know what to say... As stated many times before no words can describe how bad your service is and how bad my feeling towards your company is. It is not a case like Adele would say "I wish nothing but the best for you..." on the contrary. You make me so naar dat ek op julle wil kom kots! I have honestly not had 1 pleasant experience with you. When I joined your pathetic medical aid I advised everything regarding my bipolar disorder should be covered. I know how my disorder treats me thus I informed you prior to joining yet your info was false. You ensured me that the plan (Standard) will cover everything. You were so desperate signing me up. If you advised how useless you and this plan is I would have gone to a medical aid who actually delivers the service I deserve. I am not even closely covered in the way I should be and you assured me I will be covered for everything with regards to my condition? Where is the promise of the "excellent" service and cover now? False info much? I had to be admitted into hospital in February this year. I almost committed suicide. You refused to have me treated due to the fact that the waiting period was not over. I had to wait a few more days... unfortunately my disorder does not have a time when it hits me. I cant ask for it to wait a few days. I am at a bad state again and need help which you refuse. You stated that I was not on a medical aid before joining you. Excuse me? I have not been without a medical aid for longer than 1 month. Prior to joining you I was on Imperial med since 2002 and then joined Fedhealth for 1 month. Someone which I wish I could slap now advised you are much better (which is clearly not the case whatsoever) then I decided to join you. Biggest mistake I have made in my entire life and I regret the day I signed up with you. You make my condition worse and worse when you are actually supposed to help me but you refuse. You did not have your facts straight. I found out from other medical aids. I was not supposed to be on a waiting period. Yet so far no apology was given to me for almost costing me my life. You now eventually pay 2 out of the 5 meds that I am supposed to take which I had to stop due to you not paying and benefits always being depleated. I am so gatvol getting emails of closure of query that state benefits are depleated... It is now October and now only you are paying a fraction what I am supposed to take. My waiting period ended in February. What does that help me? I am not in a good state of mind once again. I cant afford to pay medical aid (which does not even closely cover me) as well as my medication. I had to stop taking my medication again due to you not paying. I cant see my psychologist nor my psychiatrist which I should see on a 2 weekly basis which I informed you about yet your agent who sold me the useless plan ensured me will cover all issues with regards to my condition. I email you almost every single day yet all I get is closure of query and to compliment your service? There is absolutely nothing to compliment you on! My money goes into a bottomless pit.in 1 year I pay R35976. Yet for a year I get R5232 worth of benefits? Where is the rest of the money? A total of R30744? You advised that this goes towards covering my hospital...? Yet you reject the claim? I had to pay over R4000 in cash? I got this email today. I post comments on Facebook. You blocked me and deleted my posts? My partner then posts and also gets blocked? I now created myself a new profile and posted on your wall. Will probably be blocked again and have the posts deleted. Is it because customers should not see what you do? I have posted uncountable amounts of complaints as well as emails yet you just dont care. Keep taking my money on a monthly basis. Not even the Council for Medical Schemes could assist? I emailed them but have not received feedback. When I just see an advert for you or hear your name I get naar. And I cant even go to the doctor or get medication to help with the naar feeling seeing you dont pay. I am at a very bad place in my life at this stage again which you contribute a huge amount to yet you refuse to give me the help that I need. You are one of the reasons I feel this way again in my life. I cant accept the fact that I pay and need help yet you refuse it. I am desperate to get help and you refuse. As I said I had to stop taking my meds again seeing you dont pay. You are by far the worst medical aid in existence and the fact that you are still operating completely gobsmacks me... If I had to pay the amount into a savings account that I pay over to you on a monthly basis I would have been much better off and would have been able to use that money to treat my condition. I honestly cant believe that you treat customers like this. It is actually a disgrace and disgusting. If something happens to me due to you refusing me the urgent help I need I will ensure that you are held liable and accountable! My entire family knows that you refuse to pay for my condition! I will haunt every single one of you at Bonitas so bad it will make your head spin! You honestly are not helping my condition in any way, on the contrary you worsen it! A lot! You are a service provider yet you dont provide me a service? I pay and pay and pay... for what? Getting frustrated every day? Getting refused the help I desperately need. I did not know that your mission in life is complicating mine and upsetting me on a daily basis and not helping me getting the help I need. What is the purpose of paying money over to you and get problems in return? I think it will honestly be better for me to go to a small farm hospital in the bundus where some quack can google how to treat me than getting anything out of you! The service will be much much much better than what you provide me. I dont think the words "customer service" and "paying out claims" are in your vocabulary as I really struggle to see it? You are beyond useless and do not care about customers whatsoever. Never in my life have I dealt with anything like you. You are one of a kind. I am in the customer service industry myself, but luckily I give customers the service they deserve for the money they pay. Your slogan is so false... The medical aid who never stops thinking about you? You dont think about anyone besides yourselves! Not once have you thought about me. You are just worried about money coming in. You hardly give out. I would like to know where the difference of my money paid to you went? It is always one hell of a mission getting anything out of you. I have a bigger chance getting pregnant through email or smoke signal from Ethiopia than getting good service from you. The public should see what you guys do. I had a hell of a lot of feedback on one of my complaints on another page than your Facebook page. I am not the only one who feels this way. Your service is utterly pathetic and I am honestly a very upset customer. Not one of my countless complaints have been dealt with in the manner that I deserve! Shame on you! I dont know how you guys sleep at night knowing this is what you do to customers.

Acc number - F6736214
Patient - C.M. de Beer
Med aid nr - [protected]
Referring dr - Dr J/A Myburgh
Service date - 25/07/2017
Practice nr - 5200539
Blood tests had to be dome all most as an emergency because of severe problem with my prostrate and the dr wanted these very soon and Bonitas refused to pay this.
Can you please attend to this and correct it.

My member number is [protected] and I have been quering pathcare accounts outstanding since december 2016... For invoices for in hospital treatment as well as invoices with icd-10 cide i48.9... When I started with this query in march they told me paarl medi city must confirm I was in hospital on 8.12.16 which paarl medi clinic has done three times... Your case manager auth the incorrect date... She put as from 9.12.16 and I was admitted late in 8.12.16... I have sent so many emails no response or I just get a query number and get told they attending to it... Still no payment... I phoned bonitas on 1st 3rd and 4th of aug... No one has returned my call... Pathcare is now taking me to court and im getting legal advice on monday as u dont respond at all... Received another three final notices from pathcare today so ive had enough... Reveiw my emails to u... From [protected]@gmail.com and see how manytimes I have contacted u regarding these payments... Im laying a complaint with medical aid council next week... Main member jj bosman pasient vsb bosman...

On a constant basis Bonitas keeps suspending my membership due to them stating that my premiums have not been paid. In April 2017 during an emergency in hospital I had found out that me medical aid has been suspended. I had to pay cash which was a large sum of money. Upon investigation and taking to different consultants it was discovered that in March 2017 Bonitas did not debit my account, therefore in April they tried to double debit. My bank stopped the second debit which then resulted in bonitas suspending my account. However how am I to blame for this. This is a breach in contract between the medical aid and myself. Now in June I find that my membership has been suspended again. I noticed that my account has not been debited. I called the medical aid and they were adamant that it was my fault. I had called my bank to verify the debit being stopped only to find that the medical aid did not debit my account. Now I am required to do manual transactions and send through a host of paperwork to reinstate this. I am really tired of this. I have no confidence in Bonitas

I left the Medical Aid end December 2016 after giving my full months notice.
Via snail post they sent me a letter (they have always sent me e-mails now POST?) 17 April 2017 on the letter that they need my banking details to refund me.
I have e-mailed the info on the 2nd May 2017 (not snail mail)
On 17 May 2017 I phoned to follow up just to hear it will pay out the Friday 20 May 2017. Give or take if not in by the 25 th I will phone again.
By then when I phoned I was told there is a journal opened and I will receive the money the following Friday 2 June.
2 June no money then I phoned to hear it was paid out? NOT in my account I said. The lady under took to follow up and phone back on REF # 020617Q9KHYS. Today 5 June no call no money and when I phoned and waited for 22 min to get a statement I will receive it by Friday 9 June.

Member - [protected]

My dad is a pensioner and uses the little money he gets to pay Bonitas for medical cover. BUT every time he needs an operation Bonitas say they will only pay if he pay R6 000-00 in advance.

A few months back he had to go for a back operation but Bonitas had more issues than answers. He barely can walk but Bonitas don’t care one ounce. So he lives on pain killers and has to suffer every day.

This time he has trouble with his eyes. Dr Fourie [protected]. A specialist advice that he has cataracts and they have to remove it as it could cause blindness. AGAIN Bonitas inform him that they can do the procedure if my dad pays R6000-00 upfront.

People complain about governments service but I think government patience if better of that Bonitas members. My grandmother went for cataract operation at a government hospital and was assist right away without any issues.

We know Bonitas will have some excuse and as they are a money making business who only cares about the money and not their members.

Why can't Bonitas have selutions for their members instead of just refusing to help paying members to life a better lift. You will rather have a member being blink that cannot do anything so you have more reasons not to help them.

We will take this up with the Ombudsman also

Good day. I was a liberty medical aid customer and I voted a firm No on the amalgamation of bonitas medical aid but it happened any way. I have a crown that has to be done and now all of a sudden they don't cover it in the benefits, wen I was on liberty I got one crown a year I am totally disappointed in bonitas medical aid they still charge me the same rates but with almost none of the benefits I use to have. I highly not recommend that anyone join bonitas and I am considering of suspending my suspicion. I can not belive that this is the case that they took away my denifits without consulting me first I have not agreed to any of there terms. They are a complete rip off. And if I had to give them a rating from 1 to 5 I'd definitely give them a zero. This is not what I signed up for. They are such a rip off and there advertisement lies cause I do not get what I pay for.

I am very disappointed in the unprofessional, sarcastic and don't care manner that Pryan dealt with me and my query on the 12th of January 2017.

I would want to suggest proper Telephone etiquette and Frontline Excellence courses as he definitely needs it.

Will not again going forward having him assist me with any of my queries, will call back until someone else is available.

Mrs. C. Smit
Member #[protected]