BONITAS MUST PAY!

I have a pathology claim for a certain test that Bonitas refuses to pay because according to BONITAS the path lab is using the incorrect code. TAKE NOTE.....this claim happened in OCTOBER 2017. I have been trying since November 2017 to get this claim paid and every time Bonitas says the incorrect code is being used. I have already, together with the pathology lab, sent through an official letter that shows that the test in question must use the code that the pathology lab has used and STILL Bonitas is saying it is incorrect????!! I mean how can Bonitas tell the pathology lab what codes to use or how to do their job? If the pathology lab were to tell Bonitas how to run a medical scheme, what do you think the response from Bonitas would be???? I have now phoned in countless times and email a few more times over the past TWELVE months and sent through how much evidence that the correct code is being used and still they not paying the invoice??? Now take note, these tests were done IN HOSPITAL which i was and still am more than covered for. Last year I was on such an expensive plan only so that Bonitas can just swallow all my premiums and then I must still cough up even more???!! Definitely not going to happen!

What frustrates me more is that on these same accounts with the same pathology lab Bonitas also didnt want to pay for a test that ACCORDING TO PATHOLOGY PROTOCOL MUST BE DONE IN TRIPLICATE. I had to fight and submit so much proof and evidence for the past 11 months to get them to pay ALL those tests and now all of a sudden, AFTER 11 MONTHS, all those tests can now be paid???...........how convenient that EVENTUALLY there were no issues.

To me it just seems that either the people behind the scenes, who does the actual processing of claims are not trained properly or simply just damn lazy! Because how can a claim be incorrect and have insufficient documents supp**** for 10 months and then in month 11 (and only because the paying customer has been screaming and shouting and threatening) is it correct????!!

I mean.....who are you guys trying to cheat here?? The pathology lab or me.......a loyal, paying CUSTOMER???

The call centre agents really tried to assist but those people in the pathology and specialist departments were and still are absolutely useless. The service Ive received as an up to date paying customer has been pathetic to say the least.

HOW IN THE WORLD CAN YOU STRUGGLE LIKE THIS FOR 12 MONTHS????!!!!!!

Like I've said in my emails and my calls to the call centre........I am now going to escalate this matter until that bill is settled.