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    Member - Statement Bonfit Accumulated Savings 2018

    Uploaded by

    Charles Mutetwa
    1) This document is a member statement for Mr. T.C. Mutetwa for the period ending 31/12/2018 from Bonitas Medical Fund. It details medical claims processed and paid, utilization of limits, savings transactions, and contact information. 2) Over the period, R4,136.61 in claims were not covered and remain the member's responsibility. R1,288.64 in claims were paid from the member's available savings and limits. 3) The member had R749.81 remaining in their savings account as of 31/12/2018. No amounts were owed by the member to the scheme.

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    © All Rights Reserved
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    Member - Statement Bonfit Accumulated Savings 2018

    Uploaded by

    Charles Mutetwa
    66 views5 pages
    1) This document is a member statement for Mr. T.C. Mutetwa for the period ending 31/12/2018 from Bonitas Medical Fund. It details medical claims processed and paid, utilization of limits, savings transactions, and contact information. 2) Over the period, R4,136.61 in claims were not covered and remain the member's responsibility. R1,288.64 in claims were paid from the member's available savings and limits. 3) The member had R749.81 remaining in their savings account as of 31/12/2018. No amounts were owed by the member to the scheme.

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    MEMBER_STATEMENT BONFIT ACCUMULATED SAVINGS 2018

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    1) This document is a member statement for Mr. T.C. Mutetwa for the period ending 31/12/2018 from Bonitas Medical Fund. It details medical claims processed and paid, utilization of limits, savings transactions, and contact information. 2) Over the period, R4,136.61 in claims were not covered and remain the member's responsibility. R1,288.64 in claims were paid from the member's available savings and limits. 3) The member had R749.81 remaining in their savings account as of 31/12/2018. No amounts were owed by the member to the scheme.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    66 views5 pages

    Member - Statement Bonfit Accumulated Savings 2018

    Uploaded by

    Charles Mutetwa
    1) This document is a member statement for Mr. T.C. Mutetwa for the period ending 31/12/2018 from Bonitas Medical Fund. It details medical claims processed and paid, utilization of limits, savings transactions, and contact information. 2) Over the period, R4,136.61 in claims were not covered and remain the member's responsibility. R1,288.64 in claims were paid from the member's available savings and limits. 3) The member had R749.81 remaining in their savings account as of 31/12/2018. No amounts were owed by the member to the scheme.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    Monthly Member Statement

    Statement Date: 31/12/2018


    Medical Scheme Details
    Mr T.C. Mutetwa BONITAS MEDICAL FUND

    4 Nolloth Road PO BOX 1101


    FLORIDA GLEN
    Krugersrus
    1708
    1559

    Contact Details
    Call Centre Number /Lost Cards: 0860 00 2108
    Fraud Hotline Number: 0800 11 2811
    Web Address: www.bonitas.co.za
    Email Address: [email protected]

    Member Details
    Member Number: 47500375872 Telephone Number(s): 0122531092
    Previous Member Nr: Cellular Number: 0712182560
    Option: BONFIT Email Address: [email protected]
    Option Start Date: 01/01/2018 Pay Point: 475/032/DWA - DEPARTMENT OF WATER AFFAIRSWATER TRADING ACCOUNT W
    Bank Account: ABSA Bank, Branch 632005, Current Account Number ******5183

    Member Beneficiary Status


    Code Beneficiary Type Beneficiary Name Date of Birth Identity Number Status Scheme Join Date Benefit Date Scheme Left Date
    00 Principal Member TAWANDA CHARLES MUTETWA 29/07/1979 7907296012189 Terminated 01/03/2011 01/03/2011
    Member Number: 47500375872 Statement Date: 31/12/2018 Page 2

    Limit Utilisation Summary ***


    Limit Code Limit Description Limit Type Beneficiary Name Start and End Date Limit Used Available
    01 Overall Annual Limit Family 01/01/2018 - 31/12/2018 Unlimited R1095.46

    Claims Processed and Paid to the Healthcare Professional (HCP)


    Claims Detail Claims Payment Information* Amount paid from Reason Codes****
    Beneficiary Treatment Tariff/Nappi Charged Tariff Scheme Total Claim Member Refund to Payment Payment Savings Accum
    Date Code** Amount Amount Paid HCP Shortfall Owes Member Date Reference Account
    Scheme Number
    Michael (Practice number: 0333816)
    00 Tawanda 07/12/2018 0190 339.29 339.29 339.29 0.00 0.00 0.00 13/12/2018 236571 339.29 0.00 505
    Total: 339.29 339.29 339.29 0.00 0.00 0.00 339.29 0.00
    Clicks Pharmacy-Springs Mall (Practice number: 0675938)
    00 Tawanda 07/12/2018 715825001 1046.50 0.00 0.00 1046.50 0.00 0.00 0.00 0.00 379
    00 Tawanda 07/12/2018 715825001 1046.50 0.00 0.00 1046.50 0.00 0.00 0.00 0.00 379
    Total: 2093.00 0.00 0.00 2093.00 0.00 0.00 0.00 0.00
    Nell (Practice number: 1447947)
    01 Sehliselo 10/12/2018 0190 361.00 359.70 361.00 0.00 0.00 0.00 20/12/2018 259756 361.00 0.00 505
    00 Tawanda 19/12/2018 0190 361.00 359.70 361.00 0.00 0.00 0.00 28/12/2018 274781 361.00 0.00 505
    00 Tawanda 20/12/2018 758256019 16.80 16.80 16.80 0.00 0.00 0.00 28/12/2018 274781 16.80 0.00 505/2876
    00 Tawanda 20/12/2018 795364008 65.64 65.64 65.64 0.00 0.00 0.00 28/12/2018 274781 65.64 0.00 505/2876
    00 Tawanda 20/12/2018 853569003 148.78 144.91 144.91 3.87 0.00 0.00 28/12/2018 274781 144.91 0.00 387/504/535/2876
    Total: 953.22 946.75 949.35 3.87 0.00 0.00 949.35 0.00
    Clicks Pharmacy Hartebeespoortdam (Practice number: 0338044)
    00 Tawanda 07/12/2018 715091001 496.62 0.00 0.00 496.62 0.00 0.00 0.00 0.00 379
    00 Tawanda 07/12/2018 715825001 1046.50 0.00 0.00 1046.50 0.00 0.00 0.00 0.00 379
    00 Tawanda 07/12/2018 715091001 496.62 0.00 0.00 496.62 0.00 0.00 0.00 0.00 379
    Total: 2039.74 0.00 0.00 2039.74 0.00 0.00 0.00 0.00
    Grand Total: 5425.25 1286.04 1288.64 4136.61 0.00 0.00 1288.64 0.00

    Summary of Financial Transactions (Refunds & Monies owed to Scheme)


    Date Description Payment Reference Number Transaction Amount Cumulative Balance
    31/12/2018 Closing Balance 0.00
    Amount owed by the Member to the Scheme:
    Member Number: 47500375872 Statement Date: 31/12/2018 Page 3

    Tariff/Nappi Codes Description **


    Tariff Code Tariff Code Description
    0190 New and established patient: Consultation/visit of a new or established patient of an average duration and/or complexity. Includes counselling with the patient and/or family and co-ordination with other health
    care providers or liaison with third parties on behalf of the patient
    715091001 DIDIVIR 200/300MG
    715825001 ISENTRESS
    758256019 PURBAC DS
    795364008 SINUCLEAR
    853569003 PHOLTEX FORTE

    Reason Codes Description****


    Code Reason Code Description
    379 This item is an exclusion and therefore not paid by your scheme.
    387 Claim amount reduced according to the list of medicines approved by the scheme.
    504 Claim line partially paid from savings/bonus account/Roll-over where applicable.
    505 Claim line fully paid from savings/roll-over benefit.
    535 Claimed amount has been reduced and paid at your scheme rate.
    2876 No Match found to Acute Med aPrescribed Minimum Benefits.

    Savings Transactions
    Claim / HCP Healthcare Professional (HCP) Capture Effective Savings Accum
    Transaction Nr Number / Description Date Date Amount Amount
    Opening Balance 01/12/2018 1262.45 5783.15
    180133807 Contribution Savings 01/12/2018 01/12/2018 776.00
    180316318 Additional interest earned 13/12/2018 01/12/2018 7.29
    180524278 Provisional interest earned 28/12/2018 28/12/2018 23.00
    EDI8300853726 0333816 Michael 07/12/2018 07/12/2018 -339.29
    EDI8301338043 1447947 Nell 10/12/2018 10/12/2018 -361.00
    EDI8301968678 1447947 Nell 19/12/2018 19/12/2018 -361.00
    EDI8302035132 1447947 Nell 20/12/2018 20/12/2018 -227.35
    Closing Balance 31/12/2018 749.81 5813.44
    Savings Advance for the period 01/01/2019 to 31/12/2018: 0.00
    Total Savings Available as at 31/12/2018: 6563.25
    Member Number: 47500375872 Statement Date: 31/12/2018 Page 4

    Savings Account Statement


    Savings Account Statement
    Transaction / Description Capture Date Amounts Savings Amount
    (Paid)/Received
    Opening Balance 01/12/2018 7045.60
    Additional interest earned 13/12/2018 7.29
    Savings Receipt 06/12/2018 776.00
    Claim paid from savings 07/12/2018 -339.29
    Claim paid from savings 12/12/2018 -361.00
    Claim paid from savings 19/12/2018 -361.00
    Claim paid from savings 20/12/2018 -227.35
    Provisional interest earned 28/12/2018 23.00
    Closing Balances as at 31/12/2018 6563.25
    * Retain for Tax Purposes

    Important Message
    For your convenience, all Chronic Medicine queries or updates can now be done by calling your Scheme Call Centre number mentioned above under contact details. We have an improved chronic medicine updating
    process. Ask your dispensing pharmacy to submit a claim first, as your new medicine may be listed in a pre-approved basket linked to your authorised chronic condition. You, your doctor, pharmacist or broker can contact us
    for the following reasons: * first time registration
    * a new condition or medicine that needs further motivation
    * if the claim is not successfully processed (in which case the system will generate a message to the pharmacist).
    View the baskets and register or update chronic medicine online 24/7 by logging in on www.bonitas.co.za.
    To avoid postal delays, we would encourage you to either e-mail your current claims ( valid claims within 4 months of treatment date) to [email protected] or fax to 011 758 7760
    Managed Care Funding Protocol.
    Also known as out-of-hospital Care Templates or Baskets of Care.
    Certain conditions have Baskets of Care, that will assist you to manage your condition optimally out-of-hospital. These may include doctor consultations, radiology and pathology tests. We are in the process of improving the
    way these benefits are displayed on the monthly statements, to make it easier for you to manage your condition and track your available benefits. During this process the Baskets of Care will be temporarily removed from
    your statement. This will in no way influence access to your benefits.
    Important note: Benefits may overlap in the different Care Baskets. These benefits will be combined to give you access to the higher amount of benefits and will not be added onto the benefits.
    EXAMPLE: If you have 3 GP consultations for Asthma and 2 GP consultations for Diabetes, a maximum of 3 GP consultations will be authorised, to be used for both conditions and not 5 GP consultations.
    The document(s) may contain confidential health information that is legally privileged and intended for the member only. Bonitas Medical Fund cannot be held responsible if it is sent to any other person in error or
    intentionally. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of the document(s) is strictly prohibited. If you have received this
    information in error, please notify the sender immediately and arrange for the return or destruction of these documents.
    Bonitas Walk-In Centres
    Bloemfontein: Middestad Centre, Shop C7, 1st Floor, C/O Charles & West Burger Street,
    Member Number: 47500375872 Statement Date: 31/12/2018 Page 5

    Important Message
    Cape Town (Bellville): Sanlam Centre, 2 Strand Road
    Cape Town: Icon Building, Ground Floor, Cnr Lower Long Street and Hans Strijdom Avenue
    Durban: 102 Stephen Dlamini Road
    Johannesburg: Mathomo Mall, 115 Main Street, Marshalltown
    Kathu: 6 Rietbok Street
    Kimberley: Shop no 17, Southey Street
    Lephalale: Bosveld Boulevard Park, Shop 6, Cnr of Chris Hani and Joe Slovo street, Onverwacht
    Mbombela: Union Square Unit G2, 44 Mostert Street
    Northam: 180 Botha Street
    Polokwane: Bonitas House, Ground Floor, 22 Hans van Rensburg Street
    Port Elizabeth: Greenacres Office Park, Block 6, 2nd Avenue, Newton Park
    Pretoria: Nedbank Plaza, Shop 17, Ground Floor, 361 Steve Biko Street, Arcadia
    Roodepoort: Flora Centre -Entrance 2, Shop 21 & 22, Cnr. Ontdekkers and Conrad Road, Florida North
    Rustenburg: Lifestyle Square, Shop No 23, Beyers Naude Drive
    Secunda: Grand Palace, Unit 82, 2302 Heunis Street
    Vereeniging: 36 Merriman Avenue, Ground Floor

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