To our valued members,
We recognise that some of our members have faced difficulties during our recent administrative and managed care transition, and we sincerely apologise for the impact this has had. We take full accountability for the disruption experienced by those members during this period.
We understand that healthcare is deeply personal. Any disruption to accessing healthcare services, information, support or authorisations you may need can create unwarranted distress, particularly when you or loved ones are managing ongoing or complex healthcare needs. Some members have experienced delays to the service they rightly expected from Bonitas. We are truly sorry.
As Principal Officer, I want to assure you that, our entire team is committed to ensuring that while systems and processes may have changed, your benefits remain the same. We recognise the effect that this change had on you and your family, and we recognise your patience and understanding shown while we work to strengthen our service.
We value the privilege members and our healthcare providers have entrusted to Bonitas as a medical scheme. Being entrusted with your healthcare is a responsibility we do not take lightly. Our commitment extends beyond meeting regulatory obligations – led by myself as principal officer, we genuinely and sincerely care about the health, wellbeing and peace of mind of every beneficiary. That responsibility has always been about earning and keeping the trust our members place in us when they need care the most.
Many members have shared their experiences publicly over the past few weeks. We have listened carefully to those experiences and they are shaping the actions we are taking every day.
We undertook this transition because we believe it will strengthen Bonitas over the long term. That was our decision and we therefore accept responsibility for ensuring it delivers the standard of care and service our members rightly expect. Where our service has fallen short, we remain accountable and do not intend to hide or shift blame. We are committed to being transparent with our members, addressing challenges openly and taking the necessary steps to improve your experience.
We will continue to keep you informed about the challenges we have experienced, the improvements underway, and the work that still lies ahead.
Over the past several weeks, some members have spoken and shared the areas for improvement and these have been carefully reviewed. Where urgent or life-threatening cases have been escalated to the Scheme, we have given it the highest level of triage and prioritisation. Restoring access to care has been our highest priority. While some of the processes supporting members have changed, our responsibility to members has not changed. These changes were made to strengthen the systems that support members’ care over the long term.
Our responsibility is to ensure those intended improvements deliver a better experience for members as quickly as possible.
I want you to know that this work continues around the clock and the areas where we have experienced challenges are actively being reviewed. Lead by myself, Scheme executives and Service Provider executives, our daily review and action sessions continue, as well as progress reporting to relevant stakeholders and oversight regulatory bodies. We are carefully reviewing every issue identified during this transition so that the insights gained can guide meaningful improvements and help strengthen the service we provide to members.
What we are doing to improve your experience
Some of the corrective actions already in place are focused on resolving current issues while strengthening the systems that support member care in the future. They include:
- Increasing support capacity to respond more quickly to member enquiries.
- Prioritising outstanding and ongoing authorisation requests (particularly where urgent medical care is required) because members cannot put their healthcare on hold while we improve our systems.
- Conducting additional claims payment runs to reduce backlogs, ensure claims are processed accurately and efficiently, and maintain financial compliance requirements.
- Strengthening communication and collaboration with healthcare providers to minimise disruption to member care.
- Introducing enhanced monitoring and oversight processes to identify and resolve issues as quickly as possible.
Dedicated teams have also been deployed to review and escalate complex cases requiring urgent intervention, particularly for members receiving oncology treatment and other critical care services.
In addition, a dedicated Transition Hub has been established on our website, where members can access regular updates, benefit information, practical guides and answers to frequently asked questions.
Supplementary support available
While substantial progress has been made in steadying our operations and specifically client service and experiences, we remain committed to ensuring that every member receives the access to care, support and service they expect from Bonitas.
If you continue to experience challenges, we encourage you to:
- Contact us via our call centre or customer service touchpoints should you require assistance with claims, authorisations or benefit enquiries.
- Report any difficulty accessing your benefits or services so these can be investigated and resolved as quickly as possible through our dedicated customer service channels.
- Review the latest member communications, benefit guides, Scheme Rules and practical “how-to” resources available on our website and Transition Hub.
- Escalate unresolved matters through our dedicated escalation process if your concern has not been resolved through the usual support channels, kindly include membership number and all reference numbers.
We will continue providing regular updates so that members, healthcare providers and brokers know what has changed, what has not changed, and where to find support if they need it.
We also recognise that some situations require immediate attention. Members experiencing life-threatening or clinically urgent access-to-care challenges may contact our dedicated escalation team at escalations@bonitas.org.za. We kindly ask that this channel be reserved for genuine emergencies or life-threatening situations to ensure we can respond as quickly as possible to those who need urgent assistance. Please also include any reference numbers of previous attempts to resolve the query.
Our progress
As part of our commitment to transparency, we want to share the progress we have made over the past six weeks.
During this period:
- 99,76% of claims were processed within the applicable service level agreement.
- 96% of authorisation requests were finalised within the prescribed turnaround time.
- 22 970 member enquiries received during the transition have been resolved.
- 184 836 chronic medicine beneficiaries have continued to receive uninterrupted access to authorised treatment.
- Outstanding transition-related cases have reduced by 62% during June 2026 with backlogs comprehensively cleared in claims, savings refunds, hospital authorisations and oncology cases.
- 2 914 332 visits to the Bonitas Member Zone since 1 June 2026.
- 47 958 healthcare practices are currently using the Provider Zone with 21 379 hospital authorisations submitted.
While these improvements are encouraging, we know there is still much more work to be done. We remain focused on continually improving our service and monitoring our operational performance every day.
Our commitment to your care will never change
Our members remain at the centre of every decision we make. We know that trust is earned through consistent action, not words alone. For me and my team, the true measure of this transition will not just be the systems we have changed, but the confidence our members have in Bonitas when they need us most.
Thank you for continuing to place your trust in Bonitas. It is a responsibility that guides us every single day.
Yours sincerely,
Lee Callakoppen
Principal Officer – Bonitas Medical Scheme
