EVdM
Elsje Van der Mescht

1 reviews | Active since Feb 2019

13 Feb 2019, 11:23

MEDICAL ACCOUNTS UNPAID, NO ANSWERS!

Good day. My husband is a member at your medical aid. He is on the Active Primary Care network of Ingwe. He received a list of GP's he can use when ill which was indicated on his membership application at the time and he signed for it. He went to a certain doctor as prescribed by your rules but suddenly to his dismay visits were not paid amounting to over a R1000. What is amazing is that the doctor's other patients according to her accounts lady on THE SAME PLAN had their accounts paid. A complaint was sent to Momentum in writing it was just ignored. The call centre was called promises were made of contacting him back, escalating the matter to the backoffice for possible payment. No feedback , account remains unpaid and doctor keeps sending accounts. A lady( can not remember name but should calls be listened to when recorded) indicated that the account should be paid because his current plan and the plan similar to his should PAY ACCOUNTS TO THIS SPECIFIC DOCTOR. The question remains: are we going to get an answer and in the event of repudiation of claims a formal letter stating this so that it can be taken further, are the accounts going to be paid? Does Momentum REALLY think that if you are given a list of certain doctors to go and consult that you will stray from this list AND TAKE THE RISK OF GETTING ACCOUNT. According to the doctor she was still on that specific list of doctors as a service provider. Can someone please contact my husband as soon as possible it's been months now!

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Replies (1)
Momentum Health
Momentum Health's reply13 Feb 2019, 11:41
Official
Thank you for your comment. 
 We are currently investigating your query and will keep you updated until resolution.

Kind Regards
Vuyo Sangweni