Short payments due to network docters
Dr Firer 29 258.60 .Bonita's Paid 10 778.90. Shortfall 18 479.70 :I am aware that Bonita's may reconsider covering the treatment in question if a valid reasons as to why the treatment was necessary.My first knee operation (Arthroscopy) was performed by Dr. Oelofse - ARWYP Kempton Park - July 2014.His diagnoses were all the codes above and unfortunately he could not perform the operation.Dr. Oelofse referred me to Dr. Firer. After consulting Dr. Firer I forward the authorizing codes and also contact Bonita's Call Centre confirming the quotation. I advise the call centre agent that Dr. Oelofse are not qualified to perform the operation. He could not help me with any Bonita's Network surgeon details that were capable to perform the above procedures. Sent emails and made phone calls before my operation to Bonita's.If Bonita's do not have a surgeon who can perform this operation surely it's not my fault and surely unfair that I must pay 75% of the account? I have not broken any of the rules applied to your chosen medical aid plan.Medical aid policies are not infallible and refusal to cover treatment may be unfair.