Stalling to avoid issuing an authorisation number for surgery

Good Day.

I am sad to have to resort to the extend of taking a simple application for an authorisation number into the public space, unfortunately Momentum Health leave me no alternative.

I app**** for authorisation for a rotator cuff repair after seeing 2 doctors one a specialist orthopaedic surgeon the other the referring GP, both had the same diagnosis. It has now been several weeks of stalling and continued requests for quotes (which were sent in the 1st email, if the call centre could be bothered to read the attachments), and scan reports etc by Momentum Health and still no authorisation number for the surgery. The last email states that the authorisation is pending for a prosthesis quote (no other details given), as far as i am aware there is no prosthesis required for this procedure. I am quite sure an experienced specialist orthopaedic surgeon would have included it in his quotation should it have been required he has no reason not to, evidently Momentum Health feel differently and have so far refused to issue an authorisation number.

I am in a lot of pain and and a lot of discomfort, while momentum health dilly dally finding ways to stall and not pay for claims that they are quite happy to take premiums for, it reeks of typical insurance company tactics.

It’s a complete waste of time and a lot of money seeing 2 doctors, if Momentum Health contradict their diagnoses. Every single claim put in so far for this injury (apart from the surgical procedure) has been rejected by the call/help centre. Every time one makes a claim, Momentum make it more and more difficult, and less and less is paid. They make you jump through the hoops just because they can.

What prosthesis does the Momentum Health medical advisor want a quote for ??????, it seems like Momentum Insurance Company knows better than the specialist orthopaedic surgeon as to what’s required for the surgery. Give me the details and I will do my utmost to find out who supplies the items and get a quote. The emails received from Momentum were forwarded to the surgeons rooms, but they don’t seem to know what the Momentum medical advisor requires.