Aside from the fact that we are patients first and far most, pay a huge amount for private healthcare, we still have to tolerate the incompetence that comes with it.
I had taken my son to the emergency rooms for a headache so severe; he couldn't walk much less talk. The systems were offline and the auth could not be obtained immediately (a fami**** scenario in which the auth is obtained as soon as systems are online again). This was the impression that I had until i started receiving bills from the providers.
Before I go on, I have to mention how long I waited for my son to be attended to (approximately 2 hours) because another patient (who happens to be someone known to staff) took priority over everyone else. A unit filled with staff all standing around 1 person while the rest waited. Whilst I can empathize, i too was there due to an emergency and I had the nurse saying, she will be back multiple times, before they eventually attended to him (who had been in severe pain). That was concerning not to mention frustrating.
Back to the billing. When i received the bills, I called the hospital to enquire if they had gotten the auth, they mentioned that apparently a circular was received on the 1 June 2026 from Bonitas instructing hospitals NOT to call for emergency auths, which was not mentioned upon our visit, even as a courtesy.
They then referred me to the medical aid and my ping pong journey began!
Bonitas claims that is NOT the process and that the hospital should call. I asked the agent what happens if they don't (as they insist they cannot), he said then you have to send over all the documents. Me the patient, has to send over all the docs to obtain auth! I went back and forth between the hospital and Bonitas for an emergency auth, that I still don't have!
I eventually escalated the query and to date, no one has called me back.
I called today gain to query, and i was told, they can't guarantee someone will call. what's the point of an escalation? I was promised a call back and no one calls.
Keep in mind that:
1. I have benefits which were confirmed multiple times.
2. It was an emergency (labelled orange which is a qualifying factor for an emergency!)
3. I am a regular paying consumer
4. and now i have bills which i have to account for because people who we pay to provide a service can't do their jobs!
I really wish having a medical aid wasn't compulsory in the corporate environment. It's a waste of time, money and effort. I know people that go to government that receive far better services and healthcare than the private sector!
This experience has caused more stress that one can imagine, and the lack of empathy, service and care is truly appalling!
Between the hospital and the medical aid...no one seems to know how to resolve this and no one cares for the patience playing ****** in the middle!
Very unhappy!
Desired outcome: Allocate my auth and reprocess claims
Confidential Information Hidden: This section contains confidential information visible to verified Bonitas Medical Fund representatives only. If you are affiliated with Bonitas Medical Fund, please claim your business to access these details.