EK
Ezna K

1 reviews | Active since Jul 2019

08 May 2020, 13:48

Bonitas still fails to comply with CMScript: The scourge of burns

We have submitted previous reviews on Bonitas and also submitted complaints regarding Bonitas to the Council of Medical Schemes in May 2019 and again in April 2020. Our complaints mainly relate to PMB claims for a burns survivor who sustained just under 40% burns in September 2020. In 2019 we only received the PMB Care Plan towards the end of 2019 which of course seriously complicates the processing of claims.. At the end of 2019 we were promised that we would receive the 2020 PMB Care Plan at the beginning of 2020 to prevent the issues encountered in 2019. On 18 February 2020 we received a PMB Care Plan with an undertaking that the codes for pressure garments were submitted to a review committee as these had to be added to the 2020 PMB Care Plan. It must be noted that we are still waiting for 2019 claims to the value of R9500 to be finalised for OT pressure garments.. To our disappointment the PMB Care Plan received on 18 February 2020 were poorly compiled and covered very few of the treatments motivated by the service providers and discussed with Bonitas. We sent detailed feedback on the same date as we received the PMB Care Plan. We want to extend out gratitude to Lebogang Morobane for trying to assist us and finalising the 2019 Pressure Garments OT claims and the 2020 PMB Care Plan but it seems he is not receiving the required support from the other departments. And so we are nearing mid-May and we still do not have an acceptable PMB Care Plan. Bonitas - you are responsible for the negative impact of your unwillingness to address these issue on the treatment of the burns survivor. And why should we finance Bonitas until they feel they have the time to address issues... As you are aware we are also struggling with PMB Claims related to Ampath, Deletic and others and we keep receiving excuse after excuse.. The claim for Dr Susan Coetzer of August 2019 remains unacknowledged by Bonitas and unprocessed. Karin Vermeulen at Bonitas Escalations should be well aware of this and after numerous emails from her confirming that our case is receiving the highest priority nothing has been done.. Please I beg you to take the time to review these issues and finalise them once and for all. Thank you

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply11 May 2020, 09:49
Official
Hello Ezna K,

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