SP
Sivandren P

1 reviews | Active since Apr 2014

18 Oct 2018, 11:43

Denial of claim, after it was approved!!!

I have been receiving treatment for an eye injury and surgery was the only option . We app**** for authorisation a week before the surgery from BONITAS and it was approved. A day before the surgery BONITAS withdrew the authorisation as they did not want to pay to the human donor tissue they had previously (a week earlier) approved. The surgery went ahead as the donor tissue was imported and it was a time critical surgery in terms of employment.We get tossed around between Bonitas and Medscheme which is the scheme administrator and in my opinion it is just a delay tactic to wear a person out. My injury occurred in 28 March 2018, surgery was on 25 July 2018 and until today, 18 October 2018 they still have given me no feedback and the bill remains unpaid for a surgery that falls under a PMB.

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Replies (2)
Bonitas Medical Fund
Bonitas Medical Fund's reply18 Oct 2018, 14:09
Official

Hello Ravi1976,

Thank you for submitting a comment to us through Hellopeter.

According to the email communication, we hereby confirm that the Appeals Committee have concluded their investigations and confirmed that the claim in question has been declined for payment.

A detailed letter will be forwarded to you shortly.

Regards,

Bonitas Team

Bonitas Medical Fund
Bonitas Medical Fund's reply19 Oct 2018, 12:00
Official

Hello Ravi1976,

Thank you for submitting a comment to us through Hellopeter.

According to the telephonic conversation with our representative, we hereby confirm that your concern has been addressed and this matter has now been resolved.

As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concerns to our attention when we have failed to deliver this service.

We apologise for any inconvenience caused to you.

Thanks and regards,

Bonitas Team