HS
Helen S
1 reviews | Active since Dec 2021
08 Jun 2022, 09:37
Hospital plan does not cover all hospital procedures - Money hungry medical aid
I logged a complaint last week, feedback was promised when on this platform and assurance that it will get looked into. However, it seems those were all lies. Still not even one call since lodging the complaint. Utter disgusting service received, you do not value your members, it's all about how much money the member can pay. A hospital plan that doesn't pay for all hospital procedures
Helpful (0)
Replies (3)0
Replies (3)
Bonitas Medical Fund's replyOfficial
08 Jun 2022, 10:00Hello Helen S
Thank you for notifying us of your complaint. We are so sorry to hear about this, we are glad that you brought this to our attention to resolve.
We will investigate this matter.
We appreciate your patience while we are resolving this query for you.
Kind Regards
Bonitas Team
Bonitas Medical Fund's reply08 Jun 2022, 10:00
Official
Hello Helen S
Thank you for notifying us of your complaint. We are so sorry to hear about this, we are glad that you brought this to our attention to resolve.
We will investigate this matter.
We appreciate your patience while we are resolving this query for you.
Kind Regards
Bonitas Team
HS
Helen S's updateReviewer Update
08 Jun 2022, 11:38Hi Everyone, they have rep**** privately but I choose to broadcast their official response. Kindly note, this is a hospital plan but the hospital procedure is not covered
With reference to the attached.
Kindly be advised that the requested treatment is not covered on your chosen option (Bonitas BonEssential).
Please note that the request has been sent to our clinical team for review, the treatment is deemed clinically appropriate however, the request remains declined as the chosen option does not make provision for the treatment to be done in hospital.
DENIS in no way disputes the requested treatment however, benefits are funded according to scheme rules and managed care protocols.
Attached, please find the Bonitas-2022-Benefit-Tables-V2 for ease of reference- page 46.
We trust the above is in order.
Kindly take note of the following important information.
Cover for treatment on your option at the time of processing the claim, is subject to your medical scheme rules, managed care protocols, scheme exclusions, co-payments, financial limits, and/or available savings, and will be covered at scheme tariff, provided the membership is in good standing with contributions paid up to date.
For further information contact DENIS via email on ***.
We trust that you find the above information satisfactory in address your complaint.
Kind Regards
HS
Helen S's update08 Jun 2022, 11:38
Reviewer Update
Hi Everyone, they have rep**** privately but I choose to broadcast their official response. Kindly note, this is a hospital plan but the hospital procedure is not covered
With reference to the attached.
Kindly be advised that the requested treatment is not covered on your chosen option (Bonitas BonEssential).
Please note that the request has been sent to our clinical team for review, the treatment is deemed clinically appropriate however, the request remains declined as the chosen option does not make provision for the treatment to be done in hospital.
DENIS in no way disputes the requested treatment however, benefits are funded according to scheme rules and managed care protocols.
Attached, please find the Bonitas-2022-Benefit-Tables-V2 for ease of reference- page 46.
We trust the above is in order.
Kindly take note of the following important information.
Cover for treatment on your option at the time of processing the claim, is subject to your medical scheme rules, managed care protocols, scheme exclusions, co-payments, financial limits, and/or available savings, and will be covered at scheme tariff, provided the membership is in good standing with contributions paid up to date.
For further information contact DENIS via email on ***.
We trust that you find the above information satisfactory in address your complaint.
Kind Regards
Bonitas Medical Fund's replyOfficial
08 Jun 2022, 17:28Hello Helen S
Thank you for notifying us of your complaint.
Please note that the requested treatment is not covered on your chosen option (Bonitas BonEssential).
The request has been sent to our clinical team for review, the treatment is deemed clinically appropriate however, the request remains declined as the chosen option does not make provision for the treatment to be done in hospital.
Thank you for notifying us of your complaint.
Please note that the requested treatment is not covered on your chosen option (Bonitas BonEssential).
The request has been sent to our clinical team for review, the treatment is deemed clinically appropriate however, the request remains declined as the chosen option does not make provision for the treatment to be done in hospital.
DENIS in no way disputes the requested treatment however, benefits are funded according to scheme rules and managed care protocols.
We sincerely apologise for any inconvenience caused
Kind regards
The Bonitas Team
We sincerely apologise for any inconvenience caused
Kind regards
The Bonitas Team
Bonitas Medical Fund's reply08 Jun 2022, 17:28
Official
Hello Helen S
Thank you for notifying us of your complaint.
Please note that the requested treatment is not covered on your chosen option (Bonitas BonEssential).
The request has been sent to our clinical team for review, the treatment is deemed clinically appropriate however, the request remains declined as the chosen option does not make provision for the treatment to be done in hospital.
Thank you for notifying us of your complaint.
Please note that the requested treatment is not covered on your chosen option (Bonitas BonEssential).
The request has been sent to our clinical team for review, the treatment is deemed clinically appropriate however, the request remains declined as the chosen option does not make provision for the treatment to be done in hospital.
DENIS in no way disputes the requested treatment however, benefits are funded according to scheme rules and managed care protocols.
We sincerely apologise for any inconvenience caused
Kind regards
The Bonitas Team
We sincerely apologise for any inconvenience caused
Kind regards
The Bonitas Team