Bonitas! No service, TERRIBLE !!!!

BONITAS — FORMAL ESCALATION OF XIFAXAN FUNDING APPEAL Membership Number *** I am requesting the urgent escalation of my outstanding request for funding of Xifaxan (rifaximin) for the management of hepatic encephalopathy. My request has now been under review for approximately two months, yet I have still not received a final written decision. I have cooperated with the process and provided the information requested. Nevertheless, I continue to receive the response that my case is being investigated/reviewed, without a clear indication of what remains outstanding or when a final decision will be made. This is a serious matter. Xifaxan has been prescribed as ongoing treatment for a significant medical condition, and the uncer*****y surrounding access to the medication is unacceptable. I am therefore formally requesting that Bonitas: 1. Escalate my case immediately to the appropriate senior clinical/appeals authority. 2. Provide me with a written explanation for why a decision has taken approximately two months. 3. Confirm exactly what, if anything, is still outstanding before a final decision can be made. 4. Confirm whether my request has been assessed against all applicable chronic medicine and Prescribed Minimum Benefit (PMB) provisions. 5. If funding is refused, provide the specific scheme rules, clinical grounds and applicable PMB treatment criteria re**** upon for the refusal. 6. If Bonitas considers an alternative treatment to be appropriate, explain on what clinical basis that alternative is considered suitable for my particular circumstances. I do not believe that an indefinite “under review” status is an adequate response to a request concerning ongoing medically prescribed treatment. I am asking Bonitas to treat this as a formal escalation and complaint, and to provide me with a definitive written outcome. I will provide my membership and medical information privately through the appropriate Bonitas channel. Bonitas — I have already waited approximately two months. I am asking you now to resolve this matter and provide a clear answer.