Still a ridiculous process & still no constructive feedback

<p>My reports of 15/03/2017 & 29/03/2017 are still unresolved - to a great extent. what it turns out is that the process for PMB claims was changed with minimal communication to the members - especially the transferred in LMS members. I had a long discussion on 26/04 with a senior in the PMB department who for 40 minutes quoted the process book & why it is the way that Bonitas does things. My email to PMB Dept at Bonitas of 05/05 below - and this remains totally unanswered :-</p> <p> </p> <p>I must at the outset say that much as I do agree that Bonitas is a separate scheme to LMS and therefore Bonitas Rules apply, I do find it ludicrous that I cannot expect the same level of service that we enjoyed previously in respect of my & my husband’s accepted chronic conditions & treatment plans in particular. It appears to have been missed that yes, LMS merged into Bonitas but we as members had no say in the actual process or the plans that we eventually are on. </p> <p> </p> <p>My extreme annoyances are as follows :-</p> <p> </p> <p>Both treatment plans allow for GP / Family medicine visits – I have accepted PMB Asthma which requires Lung Function test & my husband has various accepted PMB’s – needing a R&E ECG machine. So we need to go to the GP to be referred to the specialists who we have been going to for checkups for years. MAKES NO SENSE.</p> <p> </p> <p>Each treatment plan has accepted codes – none of which are what the doctor actually charges for the tests. Again we need to ask the specialist to motivate why he does the tests he does to monitor chronic conditions so that this motivation can be reviewed by your panel of doctors ? AGAIN MAKES NO SENSE.</p> <p> </p> <p>At the beginning of this year – nor at the end of last year when we received our treatment plans were we advised that these (1) specialist referral, nor (2) specialist motivation were needed. AGAIN MAKES NO SENSE – surely a bunch of not-new members being merged into an existing scheme are assisted as much as possible ? </p> <p> </p> <p>I feel that no assistance has been given to me – I first raised this query at the beginning of February when my pulmanologist account was rejected as “specialist referral needed”. ....... did assist as far as she could – you have now explained “the rule book “ to me at length – and I still sit with :-</p> <p> </p> <p>An account of R 1 800-00 which I have had to pay myself.</p> <p>A list a mile long of requirements just so that I can have my & my husbands chronic conditions monitored as they both have been for the last number of years.</p> <p> </p> <p>My husband needs to go for his annual check up soon – please would you let me know exactly what format your requirements need to be submitted to yourselves in so that I can avoid having to pay this account myself as well through unacceptable / incomplete documentation.</p> <p> </p> <p>I have purposely removed names from the above.</p> <p> </p> <p>I believe my next step is the Council of Medical Schemes.</p> <p> </p>