Confusion around the introduction of the new diabetes programme as previously communicated, with effect the 1 May 2017 we will be introducing a new Diabetes Management Programme in partnership with Medscheme. Unfortunately, the termination of the CDE programme has caused some confusion with a few doctors on the CDE network resulting in miscommunication to their patients. Bonitas would like to reassure you that your clients will continue to have access to their treating doctor and all the services required (such as those below) to effectively manage their diabetes.
Chronic medicine authorisations Authorisations will remain unchanged. No new quantity limits, medicine formularies or medicine exclusions will be imposed from 1 May 2017, including the consumables used by our members (such as strips and needles). Queries and updates relating to these authorisations can be sent to diabetesmeds@bonitas.co.za or call us on 0860 002 108.
Access to network doctors The majority of the doctors contracted to the CDE network are already contracted to the Bonitas network. The networks are open to any Family Practitioner or specialist who wishes to participate. Your clients can find out if their doctor is already on the Bonitas network by calling us on 0860 002 108; logging in to Bonitas website and using the “find a doctor” tool or by sending an SMS with the word 'Find' to 43899.
We value the expertise of the doctors on the CDE network and have invited those not yet already on the Bonitas network to join and participate on the new programme. We are already in discussions with these doctors and we anticipate that they will be encouraged by how the new programme makes allowance for the time that they need to spend on complex cases (prolonged consultations) and the ongoing monitoring of their patients.
Extensive out-of-hospital benefits for the management of diabetes Even if the doctor does not join the network, your clients can continue to see their treating doctor and will have access to cover for GP consultations, blood and other laboratory tests, dietician and podiatrist services, an ophthalmologist consultation and a visit with a nurse educator. They will receive a full list of these benefits in April.
In addition to the set of comprehensive benefits that are made available to all diabetic patients, we are aware that there are complex cases where a doctor may be required to spend extended time with a patient. For such cases, we will be providing benefits for prolonged consultations (30 minutes) and a monthly coordination fee for identified high-risk patients where the treating doctor qualifies and agrees to participate. Doctors and patients who qualify for this additional benefit will be provided with more information once the new programme is implemented.
If a member identifies that they require additional services for the management of their condition, we have a dedicated team who will review all requests received. Additional requests must be emailed to diabetespmb@bonitas.co.za
Submit claims directly to us If the treating doctor is not on the network and requires an upfront payment, your clients can submit their claims directly to us (email to claims@bonitas.co.za, post to Bonitas Claims Department PO Box 74, Vereeniging, 1930 or at submit at one of our walk-in centres). We will refund your client directly, up to the Scheme Rate.
The health of our members is our priority and as such, we have a dedicated team who will be contacting all beneficiaries currently on the CDE programme to provide them with more information and answer any questions they may have.