AS
Andre S

1 reviews | Active since Jan 2013

01 Jun 2022, 20:28

Poor poor service on all levels

This medical aid did not pay for medication prescribed by a dentist for an abscess that I had because the pharmacist used their own practice code rather than the doctors code. I don't know the price of medication and paid the amount as I thought this is what was due by me. The medical aid now want me to send them the slip, which I threw away as I don't keep slips for items bought that doesn't have a warrantee, and I could not give this to them as explained, now I have to go back to the pharmacy as they made a mistake, and I have to rectify this, and I don't know why the systems on the medical aid side or pharmacy side did not flag this transaction as an error when the pharmacist entered the wrong practice number as the medication is a schedule 5 anti biotic. This all has been explained to them and still, after I had surgery 3 weeks ago, they wont refund me until I get this info and send it to them, because it seems I am at fault. No regard for someone that is still on sick leave and have to submit documents that they can get from the pharmacy themselves as the error is between them.

On another matter, I had to pay a co-payment for my surgery, and can only claim this back from my GAP cover as soon as Bonitas has paid the hospital and have added this to their monthly statement, as this is required by my GAP cover. The bill was sent to them on 26 May, I sent it on 28 May and my wife was told on 30 May that it would be on our statement. Surprise surprise, that does not reflect on my statement, and now I have to wait another month to claim this back, as I was told in the past they don't do separate statements during the month, so I have to sit and wait for them. This in times where every cent counts to any household, but if I am late by a day with a payment, there would be hell to pay. The medical aid does work, but their admin is woeful.

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Replies (3)
AS
Andre S's update02 Jun 2022, 05:55
Reviewer Update
As I thought, an automated response. Lets see if you would go the extra mile to assist a member that has been struggling to get past your red tape for a while. It seems as though you guys make it as hard as possible to get anything out of you, for the hope of the member to just give up and then you don't have to pay what is due. The mistake was not mine, you should have paid for my medication and not me and now I have to get more proof that I actually did pay for medication that I shouldn't have, obtain this from the pharmacy that made the mistake, I sent proof that I paid, and you have it on your system that I paid, so why make it so difficult? Why did your agent tell my wife on the phone my hospital bill would be on my next statement(May) and now it does not reflect, now I wont be able to claim this for 1 more month, although I had to pay for the co-payment on 18 May and will have to wait until 1 July to claim this and then also wait for my Ga cover to process my claim?? Red tape and this results in me waiting for at least 2 months!!
AS
Andre S's update02 Jun 2022, 06:02
Reviewer Update
I am just so sick and tire to have to take this nonsense from a company that you pay on time each and every month and you cant do anything because they strip you from proper and helpful service and wont be human enough to understand your situation and just give you these blunt responses and you have to accept it, because you are at their mercy. Service delivery in SA is not just a problem at state institutions, but in many private entities the service levels have become so poor, and we just have to sit back and take this. I am sure I am not the only one that feels this way, and yes they may come back and give me an answer, but will this be resolved, I am more than confident to say no. Sorry for the rant but I have had it with being blatantly misused and patronized like this.
Bonitas Medical Fund
Bonitas Medical Fund's reply02 Jun 2022, 07:47
Official
Hello Andre 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