kK
keithc K

1 reviews | Active since Apr 2017

22 Jun 2018, 13:41

Hospital claim not being approved- despite being on hopital plan

My daughter had an emergency surgery in Sandton Medi-clinic this February 2018.

There were 7 days hospitalization, 4 General ward and 3 High care.

Momentum says that only one day high care was approved as per authorization code. The hospital has been trying since to update Momentum with all the required information but the medical aid is refusing to recognise that my daughter was in high care for those three days. Why is it so difficult to update the autho code.

I am being slammed with big accounts now due to the"short fall" that should have been covered as we are on a FULL hospital plan at an associated hospital.

Please can someone at Momentum deal directly with the hospital to get this case fixed as I have been tossed back and forward continuously between the two parties, both blaming each other for the account.

Momentum says- Mediclinic must update their autho code to the actual stay in high care

Medi-clinic says- they have updated all the records and last sent through in mid may all the details again and just don't have any response from the medical aid.

This is hugely frustrating. Can we please stop the blame game and get this sorted out asap.

Momentum reference: ********** 38.

0
Replies (2)
Momentum Health
Momentum Health's reply22 Jun 2018, 14:21
Official

Hi Keith

One of our consultants will contact you shortly to discuss.

Kind Regards

Janet Behari

kK
keithc K's update26 Jun 2018, 08:29
Reviewer Update
Janet called me very soon, after this complaint, however she said I will be contacted Monday, and no one called yesterday or left a voice message. Please can we have follow up.