Incorrect information, incompetence and tardiness

<p>On the 4 January I received an email confirming authorisation for my daughter. Please see below email correspondence. A bit long winded, but it has all the facts. As per the last email, I do not believe that the third visit should come out of my savings, as this appointment was made prior to Momentum confirming their mistake. It should come out of the PMB. Momentum was fantastic in the past, but over the last few months have really dropped the ball. Besides the below, they take rather long to reply to enquiries. Also their telephone consultants are not trained properly and lack vital knowledge.</p> <p> </p> <p>Going through the last 2 months of reviews, this seems to be the general consensus.</p> <p> </p> <p> </p> <p>From: member+ ********** ********** <member+ ********** ********** /> Sent: 04 January 2017 03:05 PM<br /> To: ********** /> Subject: Momentum Health enquiry: TM Mill ********** </p> <p> <br /> Dear Mrs Mill</p> <p>Authorisation enquiry</p> <p>Please be advised that the attached request has been approved with authorisation number ********** 3 as an exception for the period 01.12.2016 to 31.12.2017.</p> <p>The benefit will not be granted on an ongoing basis as this is non-PMB.</p> <p>Further to the above, the medication is not covered on this option.</p> <p> The reference number for your enquiry is ********** 93.</p> <p>Should you have any further enquiries, please do not hesitate to contact us at ********** or call us on ***.</p> <p>We look forward to being of further service to you.</p> <p>Kind regards</p> <p>Ayanda Gasa<br /> Service Consultant<br /> Momentum Health CorrespondenceFrom: Tania Mill ********** /> </p> <p>Sent: Thursday, January 05, 2017 8:50 AM<br /> Subject: Re: Momentum Health enquiry: TM Mill ********** <br /> </p> <p>Good morning,</p> <p>Thank you for the below email. I just want to confirm that Morgan's appointments with the psychiatrist and psychologist are covered for the next year?</p> <p>Kind regards</p> <p>Tania Mill</p> <p> </p> <p> </p> <p>From: member+ ********** ********** <member+ ********** ********** /> Sent: 09 January 2017 07:06 AM<br /> ********** /> Subject: Momentum Health enquiry: TM Mill ********** </p> <p> </p> <p>Dear Tania</p> <p> </p> <p>Benefit enquiry</p> <p> </p> <p>With regards to your previous email, please note that for the authorization number ********** 3 we have approved 2 session with the specialist (Psychiatrist) and 13 visits with the psychologist.</p> <p> </p> <p>The related claims will be covered as per the scheme and benefit rules, accordingly.</p> <p> </p> <p>The reference number for your enquiry is ********** 27.</p> <p> </p> <p>Should you have any further enquiries, please do not hesitate to contact us ********** call us on ***.</p> <p> </p> <p>We look forward to being of further service to you.</p> <p> </p> <p>Kind regards</p> <p> </p> <p>Jasveer Megnath<br /> Service Consultant<br /> Momentum Health Correspondence</p> <p> </p> <p>Tue 2017-01-24 01:17 PM<br /> <br /> ********** /> ********** /> <br /> Claims<br /> <br /> To whom it may concern at Momentum,</p> <p> </p> <p>Please see attached. As per the below authorisation of 13 visits with a psychologist, I have had 2 payments deducted from my healthsaver.</p> <p>I phoned on the 19 January at 10h10 to inquire about the first claim. Reference number of the call 265 645 195. I was assured by the consultant that it would be rectified. However, I received another claims statement reflecting that the second invoice is to be deducted from my healthsaver.</p> <p>I phoned this afternoon at 12h49, the consultant put me on hold while he was sorting out the problem. At 13h03 I eventually put the phone down, as it was taking too long.</p> <p>Please can this be rectified. This is most frustrating. </p> <p> Kind regards</p> <p>Tania Mill</p> <p>Dear Tania</p> <p>Benefit enquiry</p> <p>Further to our previous email, please note the incorrect information regarding the psychologist consultations was provided.</p> <p>We have however submitted the last 2 accounts for Mrs. T Raphael, to our claims department for reprocessing. Feedback will be provided once complete.</p> <p>No further visits will be allowed as the previous visits and the above mentioned visits were approved as an exception.</p> <p>We do apologize for the miscommunication.</p> <p>The reference number for your enquiry is ********** 27.</p> <p>Should you have any further enquiries, please do not hesitate to contact us at ********** or call us on ***.</p> <p>We look forward to being of further service to you.</p> <p>Kind regards</p> <p>Jasveer Megnath<br /> Service Consultant<br /> Momentum Health Correspondence</p> <p> </p> <p>Tue 2017-01-24 01:52 PM<br /> To: Jasveer Megnath ********** /> <br /> Good afternoon Jasveer,</p> <p>Thank you for the below email. However, I took my daughter for her third visit yesterday, as per the email stating 13 visits to the psychologist.</p> <p>Confirming that it is meant to be 13 visits with the psychiatrist and 2 with the psychologist.</p> <p>Kind regards<br /> Tania Mill</p> <p> </p> <p>Tue 2017-01-24 02:18 PM<br /> To: Tania Mill ********** /> Member ********** /> <br /> Dear Tania<br /> <br /> Claims enquiry<br /> <br /> Please note that the our clinical department has confirmed that only the two claims dated the 16-01-2017 and the 10-01-2017 will be processed from the Major Medical benefit.<br /> <br /> The above mentioned dates were paid as an exception, as the treatment is not PMB related.<br /> <br /> The authorization in place can accommodate for 11 more psychiatrist claims, which will be covered as per the scheme and benefit rules, accordingly.<br /> <br /> The reference number for your enquiry is ********** 27.<br /> <br /> Should you have any further enquiries, please do not hesitate to contact us at ********** or call us on ***.<br /> <br /> We look forward to being of further service to you.<br /> <br /> Kind regards<br /> <br /> Jasveer Megnath<br /> Service Consultant<br /> Momentum Health Correspondence</p> <p> </p> <p> </p>