STvN
Stella Tsouros van Niekerk

1 reviews | Active since Nov 2017

07 Jun 2023, 10:18

Refusal to refund co-payment in full and refusal to pay specialist in full for follow up colonoscopy

FOLLOW UP COLONOSCOPY AFTER HEMICOLECTOMY: What does this say to you? An emergency Hemicolectomy was performed on me on 7 September 2022 at Sandton Mediclinic. The surgeon stated in his written post op report that a FOLLOW UP COLONOSCOPY is needed after the serious operation. One would think the follow up colonoscopy forms part of the Hemicolectomy performed in order to check that everything inside is working as it should and Bonitas should cover the costs. WRONG!! When I went for the follow up colonoscopy I had to pay a co-payment of R5000 (which I didn't have due to financial difficulty) to the Sandton Mediclinic as my gastroenterologist was asked to do the follow up colonoscope as he was the Dr to suspect a problem in his consulting room on 6 September 2022 as I had a large mass in my abdomen that was not there before and recommended a CT scan on 7 September 2023 (I had been battling with abdominal pain for more than a year prior to this date despite going to a Bonitas Network Hospital and using their Network Gastroenterologist who failed to do a CT scan to find out the reason for my pain after an inconclusive colonoscopy in February 2022. This stint used up all my hospital allowance. The pain was so severe that I could not perform at my best on a daily basis. On 7 September I had a CT scan and my abdominal pain was so bad that I could barely keep still in order for the radiologists to get decent images. From Radiology, I was admitted to theatre for emergency surgery to fix the twisted colon (which was life threatening at that stage) and then into ICU for 7 days post op. Bonitas kindly paid everything in full for the emergency surgery. To this day, Bonitas has refused to refund the full co-payment and refused to pay the Dr who performed the follow up colonoscopy in full. Surely this is part of the Hemicolectomy to ensure that the operation was a success. I am very disappointed in Bonitas. I have been a member since 2019 and don't have many claims. At the age of 61 I will never use my "maternity benefits" but still pay my medical aid subs in full each month. Surely Bonitas can refund the co-payment in full and can pay my Dr for the colonoscopy - all part of the hemicolectomy guys! Wake up, this isn't rocket science.

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply07 Jun 2023, 10:28
Official
Hello Stella T

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