Every day Constant uphill battle for payments and refunds!
<p>And again I’m telling you,</p> <p>I live at 35 Hills Road Selection Park Springs 1559.</p> <p>I’m quite sure, I informed you of this when I moved back to my parents as I made a big deal of informing everyone.</p> <p>Advise me as to how much is being refunded to me re: Dr. Pearl consultation.</p> <p>Your company’s sloppy service of this year is becoming a daily burden to my life and increasing my stress drastically.</p> <p>Without prejudice or judicial consequence (or prosecution),</p> <p>Taryn Drazek<br />(unavailable telephonically daily from 07:00-15:00)</p>
Hello taryndra,
Thank you for submitting a comment to us through Hello Peter.
This is to confirm that we have received your comment 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
Hello taryndra,
Thank you for submitting a comment to us through Hello Peter.
This is to confirm that we have received your comment 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
Good day
Please accept our apologies for the delayed response and inconvenience caused.
Please note that the below claim was rejected as : benefits used up.
Please find attached statement giving a detailed breakdown as to how your benefits were used up.
PRACTICE NO: **********
PRACTICE NAME: MJOLI
TREATMENT DATE: 13/02/2017
BENEFICIARY: TARYN MARIANA
CHARGED AMOUNT: 883.8
Kindly update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
For any further details please call us on ***or visit our website on _www.bonitas.co.za
Regards
Reuel Banda
Good day
Please accept our apologies for the delayed response and inconvenience caused.
Please note that the below claim was rejected as : benefits used up.
Please find attached statement giving a detailed breakdown as to how your benefits were used up.
PRACTICE NO: **********
PRACTICE NAME: MJOLI
TREATMENT DATE: 13/02/2017
BENEFICIARY: TARYN MARIANA
CHARGED AMOUNT: 883.8
Kindly update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
For any further details please call us on ***or visit our website on _www.bonitas.co.za
Regards
Reuel Banda
Now a previous email said I must get a referral letter from my GP. If i get that, will you people pay for Dr.Mjoli?
In my initial email about this I stated, when i went for this consultation,I still had ’funds’...so either your company is stuffing around long enough so that I must pay as Medical Aids are trained excuse finders, or Dr.Mjoli’s rooms submitted this late. Now, you must investigate this and answer carefully, as I am posting all of this on hellopeter.com, forwarding it to Dr.Mjoli and am going to print all of this and come to head office in July.
All your company has paid this year is pay for my medication until March/beginning April this year, and gp visits. I openly have informed you from last year about my bruxism issues and have had to find help myself. I had to pay everything else and pay tens of thousands of rands for everything else, as there is always a flipping excuse, and you refunded me R500 this year, and refuse to pay my gynaecologist check up too?
Why do South African medical aids get trained to take our money, avoid any instance of payment and blame it on the ’rules and guidelines’,make excuses, but know we are petrified of the government hospital system? It is abuse! Its mental and emotional abuse, as well as financial abuse.
Where is the "self payment gap"?Where is the humanity, to investigate my statements and genuinely TRY HELP me for once?
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
Now a previous email said I must get a referral letter from my GP. If i get that, will you people pay for Dr.Mjoli?
In my initial email about this I stated, when i went for this consultation,I still had ’funds’...so either your company is stuffing around long enough so that I must pay as Medical Aids are trained excuse finders, or Dr.Mjoli’s rooms submitted this late. Now, you must investigate this and answer carefully, as I am posting all of this on hellopeter.com, forwarding it to Dr.Mjoli and am going to print all of this and come to head office in July.
All your company has paid this year is pay for my medication until March/beginning April this year, and gp visits. I openly have informed you from last year about my bruxism issues and have had to find help myself. I had to pay everything else and pay tens of thousands of rands for everything else, as there is always a flipping excuse, and you refunded me R500 this year, and refuse to pay my gynaecologist check up too?
Why do South African medical aids get trained to take our money, avoid any instance of payment and blame it on the ’rules and guidelines’,make excuses, but know we are petrified of the government hospital system? It is abuse! Its mental and emotional abuse, as well as financial abuse.
Where is the "self payment gap"?Where is the humanity, to investigate my statements and genuinely TRY HELP me for once?
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
Good day
Please accept our apologies for the delayed response and inconvenience caused.
Please note that the below claim was rejected as : benefits used up.
Please find attached statement giving a detailed breakdown as to how your benefits were used up.
PRACTICE NO: **********
PRACTICE NAME: MJOLI
TREATMENT DATE: 13/02/2017
BENEFICIARY: TARYN MARIANA
CHARGED AMOUNT: 883.8
Kindly update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
For any further details please call us on ***or visit our website on _www.bonitas.co.za
Regards
Reuel Banda
Good day
Please accept our apologies for the delayed response and inconvenience caused.
Please note that the below claim was rejected as : benefits used up.
Please find attached statement giving a detailed breakdown as to how your benefits were used up.
PRACTICE NO: **********
PRACTICE NAME: MJOLI
TREATMENT DATE: 13/02/2017
BENEFICIARY: TARYN MARIANA
CHARGED AMOUNT: 883.8
Kindly update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
For any further details please call us on ***or visit our website on _www.bonitas.co.za
Regards
Reuel Banda
Expect a referral letter by Tuesday. Then you pay Dr Mjoli.
This is utter bull****. The payment dates, amounts, and what I’ve had to cough up don’t make sense and are suspicious.
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
Expect a referral letter by Tuesday. Then you pay Dr Mjoli.
This is utter bull****. The payment dates, amounts, and what I’ve had to cough up don’t make sense and are suspicious.
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
Dear Taryn Drazek,
With reference to your query number 110617Q9ZF6D.
Kindly receive attached claim report on your day to day benefit with full details.
The claim for Doctor Mjoli dated 13/02/2017 amount of R883.00 has been rejected as limits exhausted.
The Primary option¿s Day to Day benefit covers acute medication, pharmacy advised therapy which has a sub limit, out of hospital radiology and pathology, etc. Certain specialist consultations will only be payable on referral by your GP.
As at the date of this email, you have an amount of R 0.00 available from your Day to Day benefit.
Should you enquire any further information, please feel free to contact the Bonitas Call Centre on ***, or email us at ********** should you wish to compliment on service received, please do not hesitate to use the following link;
http://www.hellopeter.com.
"Did you know?
You can access medical aid benefits, tax certificates, claims statements and any other information relating to your membership enquiries on the Bonitas website.
Register at www.bonitas.co.za today, and enjoy the convenience of having access to your medical aid information 24 hours a day, 7 days a week."
Please update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
Kind regards,
Thandi Motha.
Dear Taryn Drazek,
With reference to your query number 110617Q9ZF6D.
Kindly receive attached claim report on your day to day benefit with full details.
The claim for Doctor Mjoli dated 13/02/2017 amount of R883.00 has been rejected as limits exhausted.
The Primary option¿s Day to Day benefit covers acute medication, pharmacy advised therapy which has a sub limit, out of hospital radiology and pathology, etc. Certain specialist consultations will only be payable on referral by your GP.
As at the date of this email, you have an amount of R 0.00 available from your Day to Day benefit.
Should you enquire any further information, please feel free to contact the Bonitas Call Centre on ***, or email us at ********** should you wish to compliment on service received, please do not hesitate to use the following link;
http://www.hellopeter.com.
"Did you know?
You can access medical aid benefits, tax certificates, claims statements and any other information relating to your membership enquiries on the Bonitas website.
Register at www.bonitas.co.za today, and enjoy the convenience of having access to your medical aid information 24 hours a day, 7 days a week."
Please update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
Kind regards,
Thandi Motha.
And at that specific time, according to breakdowns your company gave me, my benefits were not exhausted. So stop fighting me on obvious discrepencies and incongruencies and PAY Dr. Mjoli.
I will report this breakdown you supp**** me with, the time lines and obvious lies and buck-passing to the ombudsman.
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
From: ********** ********** />Sent: Monday, June 12, 2017 8:58:58 AM
To: ********** />Subject: 110617Q9ZF6D - ********** 3366 - ********** 3366 [MI ********** 87]
Dear Taryn Drazek,
With reference to your query number 110617Q9ZF6D.
Kindly receive attached claim report on your day to day benefit with full details.
The claim for Doctor Mjoli dated 13/02/2017 amount of R883.00 has been rejected as limits exhausted.
The Primary option¿s Day to Day benefit covers acute medication, pharmacy advised therapy which has a sub limit, out of hospital radiology and pathology, etc. Certain specialist consultations will only be payable on referral by your GP.
As at the date of this email, you have an amount of R 0.00 available from your Day to Day benefit.
Should you enquire any further information, please feel free to contact the Bonitas Call Centre on ***, or email us at ********** should you wish to compliment on service received, please do not hesitate to use the following link;
http://www.hellopeter.com.
"Did you know?
You can access medical aid benefits, tax certificates, claims statements and any other information relating to your membership enquiries on the Bonitas website.
Register at www.bonitas.co.za today, and enjoy the convenience of having access to your medical aid information 24 hours a day, 7 days a week."
Please update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
Kind regards,
Thandi Motha.
And at that specific time, according to breakdowns your company gave me, my benefits were not exhausted. So stop fighting me on obvious discrepencies and incongruencies and PAY Dr. Mjoli.
I will report this breakdown you supp**** me with, the time lines and obvious lies and buck-passing to the ombudsman.
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
From: ********** ********** />Sent: Monday, June 12, 2017 8:58:58 AM
To: ********** />Subject: 110617Q9ZF6D - ********** 3366 - ********** 3366 [MI ********** 87]
Dear Taryn Drazek,
With reference to your query number 110617Q9ZF6D.
Kindly receive attached claim report on your day to day benefit with full details.
The claim for Doctor Mjoli dated 13/02/2017 amount of R883.00 has been rejected as limits exhausted.
The Primary option¿s Day to Day benefit covers acute medication, pharmacy advised therapy which has a sub limit, out of hospital radiology and pathology, etc. Certain specialist consultations will only be payable on referral by your GP.
As at the date of this email, you have an amount of R 0.00 available from your Day to Day benefit.
Should you enquire any further information, please feel free to contact the Bonitas Call Centre on ***, or email us at ********** should you wish to compliment on service received, please do not hesitate to use the following link;
http://www.hellopeter.com.
"Did you know?
You can access medical aid benefits, tax certificates, claims statements and any other information relating to your membership enquiries on the Bonitas website.
Register at www.bonitas.co.za today, and enjoy the convenience of having access to your medical aid information 24 hours a day, 7 days a week."
Please update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas.
Kind regards,
Thandi Motha.
Please see what I am copying directly from your email- as it was my first time this year to see my gynaecologist. And I am female. So therefore, she needs to get paid.
I had a check up and pap smear.
I will also highlight the quote from your email for others easy identification and will copy/paste the quotation right here.
"...age 2). Female members may visit the gynaecologist once a year without referral..."
Kindly pay Dr. Mjoli, as this could land up being a big media exposure and scandal, as this has been a massive burden and stress every month and day for every single claim I ever do!
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
From: ********** />Sent: Wednesday, 14 June, 14:25
Subject: 080617Q9X940 - Urgent: Re: SPECIALIST REFERRAL [MI ********** 77] - ********** 3366 [MI ********** 97]
To: **********
Dear Taryn Drazek,
Thank you for your e-mail dated 08/06/2017.
With reference to query 080617Q9X940.
We apologize for the inconvenience caused in the delay of responding to your query.
As per Scheme rules and from 01/01/2017 you must get a GP referral for specialist consultations (excluding consultations with oncologists and ophthalmologists; maternity consultations and consultations with paediatricians for children under age 2). Female members may visit the gynaecologist once a year without referral.
Your GP should be the first person to advise you about your healthcare needs. Not only does
your GP understand your illness, but he/she also knows which type of specialist is best for you to see.
The GP will assist you in consulting with the right specialist should you need to, saving
you both time and money.
A specialist referral number may be created for a maximum of 6 months.
Please always remind your GP to call the call centre to obtain an automated specialist referral authorisation number before consulting with the specialist, via the IVR (Interactive Voice Response) system on ********** 666 or on our website.
Kindly also note that a Specialist Referral Authorisation number is not a guarantee of payment of claims.
Claims will be paid as per scheme rules and based on available benefits at the time of processing. The fund will pay all claims at the Bonitas Scheme Rate. If your health care provider charges more than the Bonitas Scheme Rates, the member is liable to pay for the difference.
Should you require any further information, please contact customer services on ***or email us at ********** or should you wish to compliment on the service received, please do not hesitate to use the following link: http://www.hellopeter.com
"Did you know?
You can access medical aid benefits, tax certificates, claims statements and any other information relating to your
membership enquiries on the Bonitas website.
Register at www.bonitas.co.za today, and enjoy the convenience of having access to your medical aid information 24 hours a day, 7 days a week."
Please update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas
Kind regards,
Thabo Maluleka
Please see what I am copying directly from your email- as it was my first time this year to see my gynaecologist. And I am female. So therefore, she needs to get paid.
I had a check up and pap smear.
I will also highlight the quote from your email for others easy identification and will copy/paste the quotation right here.
"...age 2). Female members may visit the gynaecologist once a year without referral..."
Kindly pay Dr. Mjoli, as this could land up being a big media exposure and scandal, as this has been a massive burden and stress every month and day for every single claim I ever do!
Without prejudice or judicial consequence (or prosecution),
Taryn Drazek
(unavailable telephonically daily from 07:00-15:00)
From: ********** />Sent: Wednesday, 14 June, 14:25
Subject: 080617Q9X940 - Urgent: Re: SPECIALIST REFERRAL [MI ********** 77] - ********** 3366 [MI ********** 97]
To: **********
Dear Taryn Drazek,
Thank you for your e-mail dated 08/06/2017.
With reference to query 080617Q9X940.
We apologize for the inconvenience caused in the delay of responding to your query.
As per Scheme rules and from 01/01/2017 you must get a GP referral for specialist consultations (excluding consultations with oncologists and ophthalmologists; maternity consultations and consultations with paediatricians for children under age 2). Female members may visit the gynaecologist once a year without referral.
Your GP should be the first person to advise you about your healthcare needs. Not only does
your GP understand your illness, but he/she also knows which type of specialist is best for you to see.
The GP will assist you in consulting with the right specialist should you need to, saving
you both time and money.
A specialist referral number may be created for a maximum of 6 months.
Please always remind your GP to call the call centre to obtain an automated specialist referral authorisation number before consulting with the specialist, via the IVR (Interactive Voice Response) system on ********** 666 or on our website.
Kindly also note that a Specialist Referral Authorisation number is not a guarantee of payment of claims.
Claims will be paid as per scheme rules and based on available benefits at the time of processing. The fund will pay all claims at the Bonitas Scheme Rate. If your health care provider charges more than the Bonitas Scheme Rates, the member is liable to pay for the difference.
Should you require any further information, please contact customer services on ***or email us at ********** or should you wish to compliment on the service received, please do not hesitate to use the following link: http://www.hellopeter.com
"Did you know?
You can access medical aid benefits, tax certificates, claims statements and any other information relating to your
membership enquiries on the Bonitas website.
Register at www.bonitas.co.za today, and enjoy the convenience of having access to your medical aid information 24 hours a day, 7 days a week."
Please update your personal details on a regular basis, to ensure that you receive the latest updates from Bonitas
Kind regards,
Thabo Maluleka