Bonitas
Refusal to pay claim for medical services

I received a bill from the pathologists informing me that Bonitas refuses to pay their account because they require a "specified letter for purpose of test". Upon phoning Bonitas they claimed all they wanted was the dr's original pathology note. I phoned the pathologists asking them to forward this document to Bonitas. When I phoned Bonitas a week later to find out if they're satisfied with the documents they received from the pathologists, they said they're not going to pay the claim because the test wasn't ordered while the patient was in hospital. They said that they pay for pathology out of hospital from one's day-to-day expense account and the limitation on pathology only applies to pathology tests while in hospital. My complaint (s) are 1st, why didn't they say so the 1st time I phoned, i.s.o. sending me on a wild goose chase to get the dr's path note. 2nd: how many times do one go to hospital per year? why do they have a limit on hospital ordered paths when most path tests are ordered by GP's to diagnose your illness? 3rd: I could barely hear anything Nhlanhla said, their phone was so bad. I requested a cancellation form from him which after 24 hours I still haven't received.

Company: Bonitas
Country: South Africa
City: Johannesburg

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