Rejected laboratory claim---only paid in hospital????

I attach the following response from Bonitas. ( ********** 0041) This laboratory account rejected was for routine pus swab of a cancer related wound to identify the correct organism cultured to then prescribe the antibiotic required to treat this infection. Rejected reason "Only funded in hospital" I have sent copies of the cultures, an explanatory letter from the laboratory as to why this test is carried out, also photos of the wound. Surely in times where we wish to reduce hospitalisation time and associated cost this decision makes no sense and to request a motivation 6 months after the fact is laughable. Please note that my father is registered for oncology benefits for this wound.

Dear Mr. PJ Daly,

Thank you for your enquiry dated 28 July 2017.

With reference to your query number 150817Q9N6RP

The claim for Drs. DU Buisson, Bruinette, Kramer, service date 19 January 2017, for code 4653, for an amount of R247.50 was rejected as its only funded in hospital,but for further review we need a clinical motivation from the doctor for us to escalate to our medical advisors

We apologise for the delayed response.

NB: Payment of claims is based on the Scheme Rules and availability of benefits at the time of processing

LETTER FROM AMPATH WITH EXPLANATION CLEARLY INDICATES REASON FOR THIS TEST. Have requested that this get escalated but it seems now we need another motivation!!

PEASE BONITAS GO AND LOOK AT ALL DOCUMENTATION ALREADY SENT IN THIS REGARD. ON A RECENT TELEPHONE CONVERSATION THE LADY THAT CALLED ME HAS NO MEDICAL TRAINING?????