Do I have to go to the Council for Medical Schemes AGAIN?

Bonitas has failed, over and over to pay for the care and treatment of a PMB condition without a massive fight. It has taken me months and hours and hours of arguing, sending documents and dealing with misinformed and in some cases, hostile and rude call centre agents. I even had to get the Council for Medical Schemes (CMS) involved and, when the CMS asked Bonitas for justification for short paying or not paying the claims in question, they could not provide any and paid.

Here we go again, Bonitas is repeatedly rejecting the latest valid claims for a PMB condition with all of the correct codes. Why? Who on earth knows. I've reached the point where I'm asking myself whether Bonitas is simply *********** or deliberately **********.

I have supp**** motivations from the specialists concerned. I have even supp**** statements from specialists in the public sector about the treatment norms and standards in state hospitals. I know my rights and the law. The CMS upheld my valid complaint. It makes me wonder how many members who don't know their rights and don't have the time and resources to fight every day are being **********?

And if you want a reference, I have plenty! Here's two for starters 071117QGK8T1 and 211117QH8KJL.