Momentum Medical Aid - Disappointed...

Please find initial complaint below.

To date , 5 months later I am still waiting for this to be resolved. Momentum blames Netcare for incorrect rates. Netcare blames momentum etc.

At the current times we are in during Covid , This is actually a Joke.

I have received so many bills , Why pay medical aid when i could have just paid cash for the delivery.

Good day Please find below my complaint regarding Momentums poor service towards my hospital claims and to Netcare Clinton staff. Before I get into my complaint let me remind you of some of your values which I feel has not been kept to: Accountability We take ownership of our roles through our actions by being responsible and honoring our obligations to our clients and internal stakeholders. At no point during this ordeal, did anyone take ownership, and your obligations to date, have not been honored. Excellence We do everything excellently and deliver the highest standard of products, service and performance to all our stakeholders This has been the most tedious experience. After having a near death experience and still in recovery, I had too, and have to follow up daily, via WhatsApp, calls and emails. Integrity We uphold integrity and live up to what we say, doing the right thing, being honest and treating all people with respect. This is laughable, as we were referred to Clinton hospital by you, and you then advise, after I have been to them that their rates exceed your allowed rates. I am on the Momentum Evolve hospital plan and had a C section on the 16/03/21 at Netcare Clinton hospital. Please note that this delivery was not a planned cesar, this was an emergency cesar due to being in labour from 25hours and complications arose! 1. Clinton hospital is on the Evolve network. There is no Evolve Hospital in my home town and chose the nearest one 36.7Km away. Dr A Fabiyi, also on the network, was my gynaecologist. Good day Please find below my complaint regarding Momentums poor service towards my hospital claims and to Netcare Clinton staff. Before I get into my complaint let me remind you of some of your values which I feel has not been kept to: Accountability We take ownership of our roles through our actions by being responsible and honouring our obligations to our clients and internal stakeholders. At no point during this ordeal, did anyone take ownership, and your obligations to date, have not been honoured. Excellence We do everything excellently and deliver the highest standard of products, service and performance to all our stakeholders This has been the most tedious experience. After having a near death experience and still in recovery, I had too, and have to follow up daily, via WhatsApp, calls and emails. Integrity We uphold integrity and live up to what we say, doing the right thing, being honest and treating all people with respect. This is laughable, as we were referred to Clinton hospital by you, and you then advise, after I have been to them, that their rates exceed your allowed rates. I am on the Momentum Evolve hospital plan and had a C section on the 16/03/21 at Netcare Clinton hospital. Please note that this delivery was not a planned cesar, this was an emergency cesar due to being in labour from 25hours and complications arose! 1. Clinton hospital is on the Evolve network. There is no Evolve Hospital in my home town and chose the nearest one 36.7Km away. Dr A Fabiyi, also on the network, was my gynaecologist. Refer to brochure : After using Clinton hospital and your suggested gynaecologist, I’m now told that I am not covered 100% as Clintons rates are higher than that of Momentum's. 2. I was readmitted to Clinton Hospital for a day on the 21/03/2021; this was confirmed by the hospital as being due to complications relating to the EMERGENCY C SECTION that was not planned. This claim is still pending from March, we have been speaking to the hospital daily and they can confirm the number of times correspondence has been sent to you regarding your '' further proof of complications; non-disclosure; treatment plans??? Should I have passed on so you could have done a full post mortem to confirm the validity of my symptoms being related to the C Section, this is ridiculous. The hospital themselves have advised that there is always a problem with Momentum. I have seen the document confirming the admission was due to complications from the cesar. Are you insinuating that Clinton Hospital and the Doctors are acting *********ly? 3. This should be the happiest experience in my life, yet you are putting a strain on it and my recovery. PLEASE can someone resolve this matter as a matter of urgency? We have all that WhatsApp messages, emails, reference numbers and call logs all of which will be forwarded to the Ombudsman and my experience will be shared with all. Regards, an dissatisfied client;