MOMENTUM CO-PAYMENT

RE: Hospital Admission on 06/03/2025 | PMB Claim Co-Payment Refund

I am writing to formally follow up regarding the unresolved refund of the co-payment I made in connection with my hospital admission on 06/03/2025.

Despite numerous communications, it was only on 16/05/2025—nearly ten weeks after the incident and only after my GAP cover declined the claim—that Momentum acknowledged the claim as a Prescribed Minimum Benefit (PMB) and thus confirmed that the full account is your responsibility.

To date, 22 May 2025, I have yet to receive a refund for the co-payment I made out of pocket. This delay is unreasonable and financially burdensome.

I would like to understand:

Why the refund was not processed immediately when you captured the claim.

What procedures are in place to prevent delays or oversights in reimbursing members who are owed funds—especially when the error originates from within Momentum.

The legal and ethical basis for using my co-payment to settle a discrepancy between the hospital’s billing for 2.5 days versus the 2-day authorization. This seems irregular and potentially ********, particularly since the hospital stay formed part of an approved PMB.

This situation has already caused significant inconvenience, and I believe I am entitled to a prompt resolution. If this matter is not resolved satisfactorily and without further delay, I will have no option but to escalate it to external channels, including the Council for Medical Schemes and HelloPeter.

I look forward to your urgent response and confirmation of when I can expect my refund.

Sincerely,

PS NO RESPONSE FROM MOMENTUM FOR THE PAST WEEK!