Pathetic Service

This is the email i sent to the Medical on 19.03.21. I have received no response. I have a complaint with regards to your news letters and hospital authorization system you are currently running. My mother, AJ Rautenbach has been complaining of serious abdominal pain for the last 4years and went to see her GP, Dr N Koch for the countless time in week10 of 2021. After the years of complaining ,they found that she had a 7cm gallstone that required immediate attention. GP’s offices struggled a week to get her an appointment with a surgeon and advised that the only doctor they could find was at Greenacres Hospital where she would have to pay R25000 upfront for the operation. The last notice we received from Bonitas was that we as boncap members were only allowed to go to Mercantile Hospital; therefore, the GP’s assistant managed to get hold of DR Bernard Ochara at Mercantile but advised my mother that she had to pay R400 for the consultation, which she desperately did. GP’s assistant phoned Boncap for authorization and they magically approved the hospital. On the evening of 17/03/21, after seeing DR Ochara, she got very sick. Vomiting, Diarrhea, severe abdominal pain, dizziness. The next morning, we phoned Dr Ochara and he informed us to take her to his office where they will try to get a bed ready for her. We came there and they sent us home as they did not have a bed available. We later received a call from Dr Ochara’s assistant advising that we have to pay R10000 upfront for the OP, which I could understand as we received pre authorization from the medical aid. In other words, if there are any expenses the bill would only be received after the OP.

This is where I phoned the medical aid on 18.03.20, asking which hospital we were allowed to go to. The consultant advised, Greenacres. When I contacted the GP’s offices again to get a referral to the correct Hospital, they were shocked to find out that Boncap members were supposed to go to Greenacres. They had absolutely no idea either. Mercantile staff also did not know. Our doctor wasn’t available, and the admin lady requested that my mother visited another GP and go through the entire process of tests again. Which for the life of me I do not understand as we already knew the problem because of tests that were already done. And also, is the most ridiculous thing I have ever heard, seeing that the woman can barely stand.

We had to take her to casualties which took 11hours of them conducting more tests, phoning me in the morning hours for information etc.

First question: Why was no one informed about these changes? The GP’s were not informed either. These are the guys that must refer us to the correct surgeons and specialists. The incorrect hospital she was referred to did not know either.!!! So much time, money, phone calls and energy were wasted trying to figure out where we were supposed to go to in case, we had a near death experience death!!!! We pay great amounts of money for this pathetic service.

Second question, how does the medical aid require you to phone through authorisation and the approve this for the wrong hospital? And the expect us to pay cash for any medical expenses afterwards? Should they have not immediately informed us that the referral was incorrect?? Third question: Who will be refunding my mother for the consultation fee she had to pay due to this lack of communication? Sure, as hell would like a refund on all the petrol and phone calls as well. Forth question…if something happened to my mother during the struggle of getting the correct information, who would have been held responsible for this…believe me, this is not something I take lightly! Hell would have frozen over, before I let this go. When I look at the reviews on here it seems like I’m definitely not the only person who needs some changes to happen. We are all sick of this careless system you are running, a system that is not for free. A system we PAY for!!!! News flash, this back and forth system does not work! We need to go back to the old days where a doctor would tell you what was wrong with you, instead of you telling the doctor. I'm sure most of you would feel the same if this was your mother...