EK
Ezna K
1 reviews | Active since Jul 2019
22 Jul 2019, 18:02
Bonitas Hiding Away from PMB Patients
We have been waiting since Feb 2019 for an updated Care Plan for a burns patient. When you phone Bonitas you are told that you are not able to speak to anyone at PMB and that you should send an email. We have sent so many emails with promises of the query being escalated to a special committee, then to the scheme etc. etc. Bonitas also funded the pain medication, to be funded from PMB, from our day to day savings and therefore the savings are depleted. I am beyond desperate to get answers from Bonitas. We also have an outstanding bill at Milpark Netcare from Dec 2018. Bonitas tells Netcare the authorisation is in place but it seems to be impossible to get this finalised. We have had to pay many Ampath claims which should all be funded from PMB. I have reviewed other complaints on HelloPeter and it seems that Bonitas are hiding away from PMB claims. I also submitted numerous complaints to the Council for Medical Schemes with no feedback expect for a case number. Is this what one should expect from a private medical aid in South Africa. Please Bonitas can somoene at PMB contact me so that we can deal with these issues once and for all.
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Replies (3)
Bonitas Medical Fund's replyOfficial
23 Jul 2019, 13:34Hello Ezna Kruger,
Thank you for submitting your details to us through Hello Peter.
This is to confirm that we have received your information and that we are currently investigating this matter.
Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.
Kind regards,
Bonitas Team
Thank you for submitting your details to us through Hello Peter.
This is to confirm that we have received your information and that we are currently investigating this matter.
Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.
Kind regards,
Bonitas Team
Bonitas Medical Fund's reply23 Jul 2019, 13:34
Official
Hello Ezna Kruger,
Thank you for submitting your details to us through Hello Peter.
This is to confirm that we have received your information and that we are currently investigating this matter.
Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.
Kind regards,
Bonitas Team
Thank you for submitting your details to us through Hello Peter.
This is to confirm that we have received your information and that we are currently investigating this matter.
Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.
Kind regards,
Bonitas Team
EK
Ezna K's updateReviewer Update
28 Aug 2019, 14:04Dear Bonitas
We were so excited after the Hello Peter review for the attention given to our case and complaints. Unfortunately because of the broken telephone between the various departments within Bonitas I can only say that we are now in a worse situation than before. The admin burden is unbearable and even though we as the member try our utmost best to assist the information is misinterpreted and queries takes very long to be resolved. This complaint relates to the main member.
As a positive we can say that the claims related to the only dependent, who was diagnosed with breast cancer in May this year, has been smooth and I want to compliment the Oncology Department for standing out above the other Bonitas departments.
I trust that my second plea would encourage Bonitas to improve on their efficiency and to address claims dating back as far as 9 months.
Regards
Ezna
We were so excited after the Hello Peter review for the attention given to our case and complaints. Unfortunately because of the broken telephone between the various departments within Bonitas I can only say that we are now in a worse situation than before. The admin burden is unbearable and even though we as the member try our utmost best to assist the information is misinterpreted and queries takes very long to be resolved. This complaint relates to the main member.
As a positive we can say that the claims related to the only dependent, who was diagnosed with breast cancer in May this year, has been smooth and I want to compliment the Oncology Department for standing out above the other Bonitas departments.
I trust that my second plea would encourage Bonitas to improve on their efficiency and to address claims dating back as far as 9 months.
Regards
Ezna
EK
Ezna K's update28 Aug 2019, 14:04
Reviewer Update
Dear Bonitas
We were so excited after the Hello Peter review for the attention given to our case and complaints. Unfortunately because of the broken telephone between the various departments within Bonitas I can only say that we are now in a worse situation than before. The admin burden is unbearable and even though we as the member try our utmost best to assist the information is misinterpreted and queries takes very long to be resolved. This complaint relates to the main member.
As a positive we can say that the claims related to the only dependent, who was diagnosed with breast cancer in May this year, has been smooth and I want to compliment the Oncology Department for standing out above the other Bonitas departments.
I trust that my second plea would encourage Bonitas to improve on their efficiency and to address claims dating back as far as 9 months.
Regards
Ezna
We were so excited after the Hello Peter review for the attention given to our case and complaints. Unfortunately because of the broken telephone between the various departments within Bonitas I can only say that we are now in a worse situation than before. The admin burden is unbearable and even though we as the member try our utmost best to assist the information is misinterpreted and queries takes very long to be resolved. This complaint relates to the main member.
As a positive we can say that the claims related to the only dependent, who was diagnosed with breast cancer in May this year, has been smooth and I want to compliment the Oncology Department for standing out above the other Bonitas departments.
I trust that my second plea would encourage Bonitas to improve on their efficiency and to address claims dating back as far as 9 months.
Regards
Ezna
EK
Ezna K's updateReviewer Update
11 Oct 2019, 10:27Unfortunately Bonitas keeps breaking their promises and I cannot help to see the irony in their newsletter titled We're here for you when you really need us. Lebogang Morobane, Team Leader: Admin Support Bonitas Client Operations phoned me apologising and promising feedback on ALL outstanding issues by 4 October 2019. I even offered to meet him at his office in Florida but he said we can resolve the issues via email. No feedback has been received on the remaining issues and I have left two voice messages on his direct line without any response. Nedine Van Vuuren of AfroCentric escalated the matter to Fund Management - no feedback.
Bonitas send us a PMB Care Plan on 7 October which is an exact copy of the unacceptable PMB Care Plan sent to us on 29 July 2019. They have therefore ignored all the motivations sent by the specialists, OT and Physiothe******. Is Bonitas not therefore responsible for the negative impact of their tardiness on the patient's recovery?
Some of the bigger amounts owed to us the member adding up to R30k: R18k for Occupational Therapy, R2k for psychologist dating back to Dec 2018, over R4k owed for pathology, R5,5k owed for hand and foot splints dating back to Sept and Oct 2018.
The Burns patient was discharged prematurely as per the motivations send by the doctors and the member and Bonitas confirmed that The December 2018 claims have been referred to the hospital benefit management team to review in lieu of hospitalisation. No claims related to this have been approved for payment.
We previously submitted formal claims to the Council of Medical Schemes on which Bonitas responded but limited action has been taken.
The family of burns survivor Kelvin Van Baalen took Genesis Medical Scheme to court (See Business Live article dated 7 Oct 2019) also regarding PMB benefits. Why are the medical aids being allowed to shy away from their responsibility while the burns survivor and their family suffer as a result.
Bonitas send us a PMB Care Plan on 7 October which is an exact copy of the unacceptable PMB Care Plan sent to us on 29 July 2019. They have therefore ignored all the motivations sent by the specialists, OT and Physiothe******. Is Bonitas not therefore responsible for the negative impact of their tardiness on the patient's recovery?
Some of the bigger amounts owed to us the member adding up to R30k: R18k for Occupational Therapy, R2k for psychologist dating back to Dec 2018, over R4k owed for pathology, R5,5k owed for hand and foot splints dating back to Sept and Oct 2018.
The Burns patient was discharged prematurely as per the motivations send by the doctors and the member and Bonitas confirmed that The December 2018 claims have been referred to the hospital benefit management team to review in lieu of hospitalisation. No claims related to this have been approved for payment.
We previously submitted formal claims to the Council of Medical Schemes on which Bonitas responded but limited action has been taken.
The family of burns survivor Kelvin Van Baalen took Genesis Medical Scheme to court (See Business Live article dated 7 Oct 2019) also regarding PMB benefits. Why are the medical aids being allowed to shy away from their responsibility while the burns survivor and their family suffer as a result.
EK
Ezna K's update11 Oct 2019, 10:27
Reviewer Update
Unfortunately Bonitas keeps breaking their promises and I cannot help to see the irony in their newsletter titled We're here for you when you really need us. Lebogang Morobane, Team Leader: Admin Support Bonitas Client Operations phoned me apologising and promising feedback on ALL outstanding issues by 4 October 2019. I even offered to meet him at his office in Florida but he said we can resolve the issues via email. No feedback has been received on the remaining issues and I have left two voice messages on his direct line without any response. Nedine Van Vuuren of AfroCentric escalated the matter to Fund Management - no feedback.
Bonitas send us a PMB Care Plan on 7 October which is an exact copy of the unacceptable PMB Care Plan sent to us on 29 July 2019. They have therefore ignored all the motivations sent by the specialists, OT and Physiothe******. Is Bonitas not therefore responsible for the negative impact of their tardiness on the patient's recovery?
Some of the bigger amounts owed to us the member adding up to R30k: R18k for Occupational Therapy, R2k for psychologist dating back to Dec 2018, over R4k owed for pathology, R5,5k owed for hand and foot splints dating back to Sept and Oct 2018.
The Burns patient was discharged prematurely as per the motivations send by the doctors and the member and Bonitas confirmed that The December 2018 claims have been referred to the hospital benefit management team to review in lieu of hospitalisation. No claims related to this have been approved for payment.
We previously submitted formal claims to the Council of Medical Schemes on which Bonitas responded but limited action has been taken.
The family of burns survivor Kelvin Van Baalen took Genesis Medical Scheme to court (See Business Live article dated 7 Oct 2019) also regarding PMB benefits. Why are the medical aids being allowed to shy away from their responsibility while the burns survivor and their family suffer as a result.
Bonitas send us a PMB Care Plan on 7 October which is an exact copy of the unacceptable PMB Care Plan sent to us on 29 July 2019. They have therefore ignored all the motivations sent by the specialists, OT and Physiothe******. Is Bonitas not therefore responsible for the negative impact of their tardiness on the patient's recovery?
Some of the bigger amounts owed to us the member adding up to R30k: R18k for Occupational Therapy, R2k for psychologist dating back to Dec 2018, over R4k owed for pathology, R5,5k owed for hand and foot splints dating back to Sept and Oct 2018.
The Burns patient was discharged prematurely as per the motivations send by the doctors and the member and Bonitas confirmed that The December 2018 claims have been referred to the hospital benefit management team to review in lieu of hospitalisation. No claims related to this have been approved for payment.
We previously submitted formal claims to the Council of Medical Schemes on which Bonitas responded but limited action has been taken.
The family of burns survivor Kelvin Van Baalen took Genesis Medical Scheme to court (See Business Live article dated 7 Oct 2019) also regarding PMB benefits. Why are the medical aids being allowed to shy away from their responsibility while the burns survivor and their family suffer as a result.