DM
Denzil M

1 reviews | Active since Sept 2015

04 Aug 2021, 11:01

Another Excuse to not fund a claim

My 5 year old has been seeing her Paed for the past two years after multiple consults with GP's who failed to diagnose (after prescribing antibiotics / steroids etc) her with childhood asthma. Current rules (make no sense) requires a specialist referral authorisation number, which, at fault I failed to obtain (one can easily forget) and proceeded to the Paed.

My account was rejected so I requested a late authorisation - provided the GP' practice details etc. (previously done so on the app) and email after email have been declined.

Even requested this to go to fund management for approval but presume they just ignore my request.

Bonitas is getting worse and worse & how does it make sense to see a GP, and then get referred to a specialist (more money you will be paying!)... and to see a GP.

Inconsistent with adhering to their rules... if i obtained the referral auth, you would have paid the claim, so all i am doing is asking for a late auth... Excuse to NOT pay the claim!!!

0
Replies (5)
Bonitas Medical Fund
Bonitas Medical Fund's reply04 Aug 2021, 11:59
Official
Hello Denzil M

Thank you for notifying us of your complaint. We are so sorry to hear about this, we are glad that you brought this to our attention to resolve. We will investigate this matter.  We appreciate your patience while we are resolving this query for you. 
Kind Regards

Bonitas Team

DM
Denzil M's update04 Aug 2021, 12:11
Reviewer Update
Hi,

Thanks - I await your feedback.

Little background story - child had severe abdominal pain and was vomiting on the way to school. Was stool build up and prescibed pegicol to assist with this with low HB - also on chela fer. I called for an appointment and did not think about a referral at that time hence the late request. This Dr has been amazing and should be on the network.
Bonitas Medical Fund
Bonitas Medical Fund's reply04 Aug 2021, 17:14
Official
Hello Denzil M

Thank you for notifying us of your complaint. We are so sorry to hear about this, we are glad that you brought this to our attention to resolve.
 
 We tried to contact you, however there was no answer and we had a network problem.
 
 Please be advised that the specialist authorisation number has been created and the claim for Dr M Annamalai Inc has been reprocessed. Regards The Bonitas Team
DM
Denzil M's update04 Aug 2021, 17:44
Reviewer Update
Many thanks for the speedy assistance.
Bonitas Medical Fund
Bonitas Medical Fund's reply05 Aug 2021, 23:36
Official
Hello Denzil M Thank you for submitting a comment to us through Hellopeter. According to the email communication, we hereby confirm that your concern has been addressed and this matter has been resolved. As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concern to our attention when we have failed to deliver this service.

We also encourage you to take time and revisit your review, it will mean a lot to us. We apologise for any inconvenience caused to you. Thanks and regards Bonitas Team