KS
Khanyisa S

1 reviews | Active since Feb 2013

27 Sept 2016, 14:11

Bad Service

<p>My membership number is ********** 9356. On the 3rd of May 2016 my son was admitted in hospital and Lancet laboratories did some blood tests on him however Bonitas has rejected one of the claims and stated that a wrong code was used for the claim. They say that they have requested lancet to change the code and put the correct one but they refused. I have also queried this with lancet and they refused to change the code and say the medical aid does not cover code 4439 that is why they are not paying. I have spoken to Doreen, Thandeka and Palesa at Bonitas who confirmed that this code is covered. I then requested them to send me a letter on Bonitas letterhead that confirms that 4439 is covered and the reason for rejecting the claim so I can take the matter up with lancet. To date I have not received the letter after requesting it a numerous times since begining of August. On the 12th of September Palesa typed it while I was on the phone with her but when I received the email there was no attachment, I then responded immediately to the email stating that there is no attachment on the email but I received an automated response that told me about the rejected claim. On the 19th of September 2016 I followed up again and spoke to Besana who said he will inform Palesa to call me back since she knows the story but till today there is no feedback and I still have not received the letter. Palesa had informed me that lancet is claiming for cronic tests whereas they performed normal tests, so this the information I wanted to be stated on the letter but it is not being send to me. I need to Bonitas to make me understand how do they expect me to resolve this matter if they are not providing me with the information that I need and they are not willing to send me proof of what they are saying? I am not willing to pay for something I am covered for and we will not be blacklisted for something we could have fought for or Bonitas will have to clear our name as they are failing to deliver on their side.</p>

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply27 Sept 2016, 15:25
Official

Hello Lingomso,

Thank you for submitting a comment to us through Hello Peter.

We do acknowledge your comment and feedback will be provided shortly.

Kind regards

Bonitas Team