Momentum gives old people the runaround!!

Yet again, we are being given the runaround regarding the claim lodged under *** and the reason for non-payment. Since last year, we have noted THREE DIFFERENT REASONS for this claim not being approved to date. For clarity - have a look at all correspondences sent and received regarding this matter.

When I lodged a complaint on 11 January 2021, the response received from Jasveer, was that the billing codes from the GP were not correct and he proceeded to provide codes and even emailed the GP so that the invoice could be corrected. At no stage did he state that a covid test by a GP is not covered!!!!

A subsequent email from Adrian then indicates that the test is not covered and that the diagnosis code on the claim is omitted. How can that be when the doctor has now included the codes which your offices have provided?

Is Momentum not supposed to advise their clients of a repudiation within a reasonable time? I am very certain, that your offices have been non-compliant in this regard. Furthermore, the reasons given for the non-payment of the claim has changed on numerous occasions and is in contravention of the TCF principles.

Also, I want to know what needs to be amended on the invoices submitted as this will be the third time such a request is being made (i.e what code must the GP now use?). If it is your opinion that this claim is not covered, please send me a formal repudiation letter.

I shall await your response before I determine if this matter should be reported to the relevant ombudsman. I am sure they will be interested to also find out why the reasons for non-payment of this claim have changed on 3 different occasions since last year.

It is my belief that Cover and Compensation for the bad service must be considered on this matter.