Poor service resulting in prolonging of injury.

Firsts things first. PMB is a department of Bonitas and they should be held accountable for their own departments. 1 Sept 2018: Bonitas never issued me with a medical aid card and seeing I was unconscious at the time of my accident I got taken to a Public hospital. I had to ask one of my personal friends to transport me to the private hospital. The hospital relocated my shoulder in theater and I knew I had physio lined up for recovery. In the six weeks that my shoulder had to stay immobilized I did all the queries I could to ensure I go straight from the surgeon to the physio. This however through PMB has been an entire nightmare. I contacted Bonitas to find out what I required from the Physio. They told me she should just write a motivation. I queried again and was told that that was all that was needed. I gathered everything from Dr's notes to Xrays and finally the Motivation letter from the Physio and submitted the claim to PMB on 22.10.2018. Beforehand I explained to Bonitas that the Physio is critically important and that it should make part of the mobilizing in theater at hospital. It's part of the treatment to fix a broken shoulder and should therefore come from the medical benefit rather than day-to-day benefit. After seven working days I contacted PMB which told me that their ten working day turnaround time had not surpassed. I told them that I am well aware of this but that my shoulder was stiffening up more and it's prolonging if not damaging the recovery of my shoulder the longer I leave it without treatment. Again they told me the same that their turnaround time had not surpassed. As if I didn't hear the first time..... The unprofessional manner that this call was dealt with directly proportional to the treatment I have received up until now. They eventually responded on 02.11.2018 that they required more information. This left me rather furious as I enquired beforehand to ensure I have all of the relevant information before I submitted my claim/authorisation. If I could do my homework then why couldn't Bonitas? I had to get additional information which took another couple of days and almost another week later submitted everything on 07.11.2018. Ready like clockwork it would take Bonitas another ten(Exactly ten) working days to respond and decline the claim seeing it didn't measure up to a specific medical code they demand on.

No one ever contacted me to grasp the severity of the injury or understand what the necessary treatment was. All that happened is that I was treated like a robot and coded according to a specification. A nice automated response to inform me that R22000 per annum was not good enough to fill their coffers in order to cover my medical benefits.

Utterly disappointed in the service received from Bonitas and it's not just a thing of declining my claim. It's the prolonging of my injury and recovery of my shoulder that you couldn't process seeing that you had a "TEN WORKING DAY" turnaround time that was key to your response. No urgency to a patient's needs. No need to tell me like you did in other reviews that I need to communicate with you on email directly. Please give a proper response online for everyone to see how you really resolve matters My medical aid number is ********** 1952