WORST MEDIACL AID EVER

Added to the below that was emailed on the 8th of January and the 10th of January and on the 18th of January, I must have spoken to another 8 or 9 people. A lady named Leonie contacted me on 23 January saying that she will come back to me soon with a reply and I am still waiting. You expect the patient to to everything. You expect the patient to obtain authorisation with information the patient does not have and will not be able to obtain. So easy for you, you throw out the claim and then it is back and forth and refusing to assist in any way. But you expect a monthly costly installment from pensioners every month. What are we paying for??? To get *****ed and to receive no customer service whatsoever. Just Bonitas blaming Netcare and Netcare blaming Bonitas. Your customer service is the worst ever. You are the worst Medical Aid ever. I will not suggest you to anyone ever. On 23 November 2023 my mother went to the Emergency Rooms at Krugersdorp Private. She was unable to pass any urine.

On arrival at the hospital, NO ONE asked her about allergies or any other medical questions. They immediately put her on a drip.

They then wanted to admit her into hospital and demanded a 35% down payment from my Dad. When my Dad told them that he does not have 35% funds to put down a payment, the doctor instructed all staff to remove the drip immediately and let my parents go. They did however fit a catheter. My parents were not given any paperwork, forms or whatsoever.

Neither of us were aware that it is our responsibility to obtain an authorisation number – but I will get back to this point

I received a statement late December 2023 from Netcare Krugersdorp and I only received the invoice on the 3rd of January 2024.

I emailed Bonitas on the 3rd of January requesting why no claim was done etc. I received an email back on the 4th from Cindy Cambell stating that the claim was rejected because not authorisation number was requested for an admission to hospital.

I made contact with Bonitas (Boncap) call centre on the 5th of January 2024 where I spoke to Tshego. Tshego informed me that irrelevant of ER visits or admission that the Case Manager at the Hospital needs to obtain an authorisation number from Bonitas to submit a claim. She provided me with the Case Manager details – Cindy Strauss. I have emailed Cindy in the meantime but she is currently on leave. Cindy came back to me stating that it is a blatant lie from Bonitas that there is a Case Manager on Emergency Visits.

I then received and email from Jodine Court that the claim will stay rejected as the medical is depleted. The Medical aid is NOT depleted!!!

I contacted Bonitas (Boncap) again today. I spoke to Wendy, where she informed me that it is the member’s responsibility to obtain an authorisation number - PLEASE TAKE IN ACCOUNT IN THE SAME BREATH I am notified that my parents should phone for an Auth number but must also provide the department with Codes and Practice Numbers and all sorts of other numbers and procedure codes to obtain an Auth number – My question being:

How on earth do you expect my parents to provide all these numbers and codes without any paperwork provided to them from the hospital. LOGICALLY it would then be in the best interest of the Hospital to provide all this information as they EXACTLY know what is required and how to obtain the Auth Number.

I was transferred to the Authorisation Department where I was informed that even is we were not aware of the Auth No we are still liable for the account.

I contacted again and spoke to Lorisha, who informed me that the best department to speak to is the Case Manager at Bonitas. She also stipulated that it is actually the Hospital that needs to obtain an Authorisation number as the Hospital will have all the codes and numbers required to obtain authorisation. I have left a message with Lisa for a Case Manager to phone me back.

In regards to the knowledge of obtaining an Authorisation number: I am only aware that an Authorisation Number should be obtained when a member is admitted into hospital. My mom was in the Emergency Room on the 8th of October 2022 as well, and everything was sorted by the Hospital in regards to claims etc. At no point were we asked to obtain an Authorisation Number or anything of the sort.

I need a Case Manager to contact me urgently in regards to this situation.

My parents are pensioners, the are in old age and they do not have the means to contact Bonitas, no to mention that they are Afrikaans speaking and there is not always an Afrikaans person available to assist them.