Bonitas
Non-payment for PMB condition

All requirements were followed ie. obtaining a GP ref.no for my mums visit to a cardiologist, which was vital before having a minor op done as she has Unstable Angina which was disclosed in Application documents in 2011. The consultation was paid for but not ecg's etc., I queried this as this was a PMB condition, this was escalated an rejected for the ffg.reasons: she has had no recent admissions for the condition (I would think this is a good thing as wouldn't want my mum to have a heart attack for an ECG to be covered) and is not on chronic medication. Not happy with this I informed them she is not on chronic medication as her medication is not on your formulary (which is bought) and not being admitted for a chronic condition recently does not make it go away, and the condition was disclosed on the application. Now they would review again only when the treating dr sends a detailed motivation to the medical advisors. Before anymore time is wasted, I have settled the bill with the cardiologist and forwarded him the email requesting the motivation. I do not want to be frustrated any further by pathetic and rather sad excuses. THIS IS WHY PEOPLE GET ADMITTED TO GET TESTS DONE!

Company: Bonitas
Country: South Africa
City: Pietermaritzburg

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