Bonitas Medical Aid declines to settle a surgeon's fee and tries to pass the cost burden to the patient

Patient Mrs. MM. Maserumula finally got the surgerydone but after a struggle and fights with Bonitas. So on the day of the operation 18. 06.2020 Bonitas eventually approved my mother's procedure but just in the nick of time while being pushed to theatre. The doctors were willing to proceed with the surgery because they were all afraid of the outcome and her ability to survive a rare fatal cancer diagnosis due to her age. The doctors, their assistants and I were on the phone for hours at the same time waiting for approval I am grateful for the doctors.

However, Bonitas did not pay the Dr L Van Schalkwyk's fee for service date of 05.06.2020 to the amount of R518.8. I enquired with the doctor's office and was informed that Bonitas Medical Aid initially rejected the account as the morphology code was omitted, the doctor added the code accordingly but the claim then rejected saying that there was no authorization obtained. R518.8 might seem like a small amount but when you pay R3888 per month in premium it's not free or charity or pro-bono, that's your guarantee for unforeseen medical events. My mom is not going to pay a cent towards this claim because Bonitas Medical Aid is liable for the cost. Bonitas also didn't pay Drs Gritzman and Thatcher in full for two biopsy pathology tests. One was done as a pre- surgery biopsy to test what was the thing in her body and the second was done after the tumor was surgically removed histology to test what it was. My mom is now forced to pay the difference that the medical did not pay for, for a in hospital procedure? This is ridiculous. My mom's surgery was an emergency procedure not planned, even if it were a planned procedurethe pathology and surgery fees would still be settledin full by the doctor. Bonitas please just do the right thing for once without your clients having to fight for the right to medical health insurance that they pay for?