1 reviews | Active since Nov 2016

20 Sept 2023, 12:44

Unpaid pathology claims

Prior to hospitalization we had my son (Dylan Swart) at the GP and the ENT, he got antibiotics both times and other meds but nothing seemed to work, he only got worse. Eventually he was admitted to hospital on 27 February 2023 by Dr M Mollentze at Eugene Marais Hospital, with unexplained excessive coughing, shortness of breath, spells of choking etc. She had a lot of blood work done through Lancet, sputum through the fisio, heart sonar through cardiologist and lung x-rays and test through the radiology dept and pulmonologist. She had to test everything because my son stopped breathing at times without any explanation. On 2 March 2023, the test came back stating that he had whooping cough, all other test came back negative.

Since Feb not all the tests done through Lancet has been paid. I had to phone Lancet after receiving sms's in July to find out what went on. After numerous calls and emails (between Bonitas, the Dr and Lancet) I sent everything myself to the fund that they requested (Lancet also sent the documentation as requested but Bonitas necer received it), 2 motivational letters from the doctor, requests and results for the blood/sputum tests done.

After I sent all this numerous times they will say they still need something else.........that I already sent previously and had to resend. Now they say that some tests won't be paid as "the patient does not meet the funding criteria".

What in the hell does that mean? My son was sick with an unexplained illness, everything had to be tested. Was Bonitas ever there to see my child, examine my child or care for my child while he was sick at home or in hospital?.....NO.....so how can someone behind a computer decide that he does not meet some or other criteria????!!!! The benefits on my schedule only say "Unlimited, covered at 100% of the Bonitas rate" (I have a picture of this and it can be sent if needed). Nothing there says that a patient needs to MEET ANY CRITERIA!

I want rhis account settled with Lancet as Bonitas is causing me to have a bad record because of their incompetence.

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Replies (3)
Bonitas Medical Fund
Bonitas Medical Fund's reply20 Sept 2023, 12:47
Official
Hello   Erika 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 
's update21 Sept 2023, 09:46
Reviewer Update
Wow, just wow.......how useless you are. Got an email this morning stating that the IN HOSPITAL blood test won't be paid because apparently something has to be detected in those tests before you pay for this! Why would any sane Doctor test for everything if they knew exactly what the problem was? Isn't that the whole reason behind getting blood tests done? Being able to pin point what the problem is from the results. If the Doctors knew what was wrong or what the patient was allergic to just by smelling the patients, then bloodtests would never be needed, don't you think? But unfortunately I don't think ANY Doctor is that advanced or evolved.

I need PROPER and VALID answers and feedback......please!
's update28 Sept 2023, 12:30
Reviewer Update
8 days have passed and I still haven't heard one single word (except for this simple generic reply) from Bonitas......definitely NOT a medical aid for any south african!