Contract breached, valid claims unpaid, absolutely impossible to get managerial intervention

As I write this review the irony of it all is that I am a financial adviser and actually a broker for Bonitas Medical Scheme but, even I, have had it in chunks with them that I cannot at this stage even consider pointing my clients in their direction - after 17 years in the industry this must be close on the worst service I have ever received. Where to start..... 1. I am registered for high blood pressure and am entitled to a stress ECG at a "Specialist for Family Medicine" (whatever that means) - my GP does not have the equipment for such a test and referred me to a physician to do this. I then phoned Bonitas (and I have a reference number for the call luckily!) that they confirmed that this can indeed be done by a physician. When the physician phoned Bonitas after the test to put through the claim they were told that I would have to pay myself as the test can only be done by a GP!!!! Firstly virtually no GPs have this equipment and secondly they confirmed the day before I went that all was in order!!! This is certainly a claim for the ombudsman should Bonitas not pay. 2. A benefit on the Medical Scheme of Bonitas is the "Wellness Extender Benefit" which pays out a certain amount towards things that would otherwise be paid from savings or your own pocket (such as GP consultations, physiotherapy, etc), (the amount depending on the plan you are on) if all screening tests have been done and are registered for this. Both my wife and I completed the screening tests and registered for this benefit. I have now submitted 7 bills all with correct ICD 10 codes and all listed as things that are covered by the Wellness Extender Benefit. All you ever get back from Bonitas is an automated email that you cannot reply to!!! I escalated this and asked for a manager name with whom I can talk or anyone for that matter that I can at least follow up on instead of having to call the call centre and have to explain everything from scratch every single time...... Not even an email thread that can be followed as there is never anyone assigned to any case - hence no accountability. I received emails that the accounts had been rejected as I had no savings! The more I emphasised that this was not a claim against savings but a Wellness Extender benefit the more I received emails stating that the claim was rejected as I had no savings!!! Eventually I got through to someone who then told me the claim was now rejected due to incorrect ICD 10 codes being used - I found it very difficult to believe that each and every one of the accounts I sent it had doctors using incorrect codes! I have many more bills that qualify but cannot waste my time sending more in as this is obviously a complete farce. When I asked what was wrong with the ICD 10 codes and what the correct one should be that I could ask the service provider to correct it I was told the service provider knows what the codes are!!!! 3. Pharmacy Direct and chronic meds - you are wasting your own money here too. Not only my wife who has asthma but also 100 other clients I know get certain meds delivered every month which they hardly ever use - the one pump is expensive and is used now and again and if she were able to get it over the counter she would probably get one every 4 months or so - we now have piles and piles of expensive meds which come every month and are not used. On the other hand, when I claimed an asthma med for my child which is cheaper and is also registered on chronic it was refused as not being on the formulary but they cannot advise any other substitute for this??? I have clients on chronic meds who are now leaving Bonitas because they often get late delivery from Pharmacy Direct and they run out of medication. I was registered for hypertension and send my script etc in over 2 weeks ago and received nothing - eventually when I phoned to find out what was going on I was advised it was because there is a co-payment of R29. For crying out loud now I do not receive urgent chronic meds because of a R29 co-payment - they say they tried to contact me - obviously not very hard as I did not even have a missed call or email from them. Either way the meds arrived yesterday and, for some reason unexplained, the following 3 months meds have been received with 3 invoices - all identical but for the fact that for this month only on exactly the same meds and pricing there is a R14 co-payment (does not match what was told on the phone) and there is NO co-payment for the next 2 months???? I have the bills to prove this. How on earth can I promote and sell a medical aid with this level of service and no managerial intervention possible. I look forward to hearing from someone of authority soon so that we can resolve not only my issues but also my way forward in having a contact person for issues for my clients. I have a large book of medical aid clients so need to know if Bonitas must be an option going forward.