Back and Neck Programme ****, Refusal to pay claim

On the 21/11/2023, I called Bonitas to inquire about the Back & Neck programme. The call centre then transferred me to an agent that deals with the back & Neck programme. She asked me a few questions and then said I should go to DBC for an assessment, thereafter if I qualify then I will start my programme. I received an authorization on the same day and a pamphlet on the programme.

On 30/11/2023 I went for my initial assessment at DBC and thereafter they took my medical history, explained the cause of my pain and made me complete forms as I will be starting the programme. I started the programme in December 2023. A claim for the initial assessment was settled by Bonitas in December 2023.

In January 2024, I continued with the programme and a claim was sent by DBC on 14/02/2024 for all the session I have had so far. To my surprise, the claim was declined. The service provider resubmitted the claim a couplee more times and the claim was still declined, all stating that I do not have any benefit. All this time I thought I was part of the programme so what do they mean I do not have benefits.

I called Bonitas, Back & Neck, on 21/02/2024 to find out what was happening. They told me they alo do not understand why the claim was rejected and transferred me to the claims department where I was provided with the same information I see on claim, I asked them to escalate. I called the claims department again on 26/02/2024 and still nothing was done, I asked for another escalation. I further inquired from the Back & Neck programme that because my initial authorization period was 21/11/2023 - 20/02/2024 and my sessions are not complete because of the December holidays, I was advised that my authorization period will be increased to 30/03/2024 so I can continue with the sessions.

Today, 05/03/2024 after 2 weeks of calling Bonitas, I receive an email from the claims department stating "I was registered with the DBC program from the 21/11/2023 till 20/05/2024 and were allowed one consultation with a GP. The benefit was used up on the 30/11/2023. I should contact DBC for an update on the registration." I have been talking to the DBC for the past 2 weeks and no one told me anything on registration. Furthermore, when I enquired about this programme, I was told I should finish my sessions within my authorization dates so what registration is this that is suddenly required. What was the forms I filled with DBC for? Was that not registration? No one seems to know what they are doing at Bonitas, you are messing with my health and finances. Who is supposed to pay this claim? Whose fault is it that my registration was not done? I will definitely not pay it. The unemployment rate is so high in this country, if you guys do not want to do your jobs please give the people who are sitting at home your jobs so you can rest because you are tired. Why is no one taking their jobs seriously? I spend almost 20 minutes on calls with Bonitas weekly, because no one knows what they are doing. Please sort this out.