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sam.b.rojo sam.b.rojo

1 reviews | Active since May 2016

14 Nov 2017, 16:20

They say they'll pay for a procedure, then they don't! Furious!

Momentum Health gave me authorisation for a procedure I desperately needed to have on my jaw. They sent me a document stating that they would cover a portion of my doctor's account and I would be liable for the rest. No problem and I was very grateful that they were going to be covering the majority of my doctor's account, so I went ahead with the procedure.

A few weeks later, I receive a statement from my doctor saying that Momentum Health had only paid them from my Health Saver - which was not meant to be touched. I phoned momentum to sort it out, the consultant said she sees the error and would resubmit the claim. She also said that the error would be corrected, including putting money back into my Health Saver.

I phoned on Thursday 9th November to enquire again to make sure that the account was paid as I had already paid my doctor the shortfall and need to claim this amount (nearly R3000) from my GAP cover. I was told that nothing had been done about it and that this new consultant would resubmit it. She told me to give it 4 working days for the payment to be made to my doctor and to check up on Tuesday, today. Today I phoned and spoke to yet another consultant who was very helpful and who said he would resubmit it as the lady who helped me on Thursday made to sense on the application so it was rejected.

I have now phone a total of 3 times regarding this claim. 3 times I have been told to wait. Twice I have been let down.

I have 4 months from the date of the procedure to claim any money back from my GAP cover. If I do not submit the final document (a Momentum Health Statement showing that they paid my doctor) I will lose nearly R3000. And on top of this, my doctor, who I am sure is extremely frustrated by this, is now demanding that I pay them the balance of R3300!

Every time I phone, I am asked to wait a few days. Clearly nearly 3 months isn't long enough for them to get this one, simple claim sorted.

Absolutely DISGUSTING service from them.

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Replies (2)
Momentum Health
Momentum Health's reply15 Nov 2017, 07:53
Official

Good day Mrs Berrow

thank you for bringing this enquiry to our attention. I will be contacting you shortly to obtain your medical aid details and investigate your enquiry.

Kind regards

Jody Saunders

Momentum Health
Momentum Health's reply15 Nov 2017, 09:11
Official

Good day Mrs Berrow

As discussed your claims related to Dr Fakir date of service 28/08/17 has been reprocessed accordingly. I trust all is in order. if you have any problems you may contact me directly.

Kind regards

Jody Saunders