MC
Murray C

1 reviews | Active since Dec 2013

15 Sept 2022, 10:11

Bonitas following their bureaucratic rules even though it costs them more money.

I suffer from colon problems and generally have to have a scope from the bottom end every year or two. I have a Bonitas Care plan which covers this. Recently I have had problems in swallowing and my GP sent me to my normal surgeon . My surgeon decided that I required a Gastro Endoscopy ( this is a scope of the colon done though the mouth.) To have this done I required Bonitas Hospital Approval which I obtained. However after talking to the surgeon I established that I could have the Gastro Endoscopy done in his rooms and that the procedure would take between 30 and 60 minutes. To save the hassles of having been admitted to hospital and to save Bonitas hospital fees, i decided to have the procedure done in his rooms. Never once thinking that by doing this it would end up by costing me more money. Bear in mind I had already been given Hospital admission procedure approval by Bonitas. However when I received the account from the laboratory for the tests I sent the account to Bonitas for them to pay the shortfall. But no because I have exhausted my medical expenses and because I did not have the procedure done in Hospital they have refused. How does this make sense. The total account to Bonitas is much less , as they dont have to pay the hospital fees, but because of a problem with the codes I have pay the shortfall.

What I have learned from this is that in future I will have every procedure done in hospital. It also explains why so many Bonitas members go into hospital when not required just to avoid costs to them. Bonitas this really smacks of following bureaucratic procedures . I would really like to know from Bonitas what the total bill for my procedure including hospital fees as against me not incurring hospital fees. I am sure that Bonitas wont disclose this as it will really make them look stupid and maybe explain why our medical aid costs are so high.

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply15 Sept 2022, 11:31
Official
Hello Murray C

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