More affordable healthcare benefits for more students for less.
Feel safe and secure with Momentum Medical Scheme - Partnering with over 1 million students over the past 30 years.
New horizons and hope in a changing healthcare landscape
Feel safe and secure with Momentum Medical Scheme - Partnering with over 1 million students over the past 30 years.
New horizons and hope in a changing healthcare landscape
Your claims statement will be emailed to you. Please ensure that you update your email records.
Tips to read your statement
Go to the pay code column
| CODE | REASON/EXPLANATION | What does it mean? |
|---|---|---|
| 28 | Claim paid to provider at Scheme rates - member to pay difference | The provider claimed more than the 100% Momentum Medical Scheme contracted rate and the difference is now due Only portion paid - member needs to pay balance |
| 65 | No day to day funds available to pay this claim | The benefit requires pre-authorisation and must contact us only if they have not previously claimed. |
| 252 | Savings depleted | The benefit is not covered on the option and you do not have HealthSaver to fund the claim Not paid - member needs to pay account in full |
| 293 | Medicine or item not covered by the Scheme | Refer to benefits of your option. Go to "tools" on the website to access more information on your healthcare benefits Not paid |
| 521 | Paid from Momentum Primary Care | Although the amount reflects R 0.00 under payment and benefit sections - it is paid in full as you consulted a network provider - doctor, dentists or optometrist No payment due |
| 529 | Claim from a non-network provider. Member liable | You did not request authorisation and must contact us for a late pre-authorisation if you have not used your out of network / casualty benefits before Not paid |
| 531 | Referring doctor is not a network provider. Member liable | The specialist you consulted was not authorised and must contact us for a late pre-authorisation if you have not used your specialist benefits for the year before Not paid |
| 545 | Tariff billed is not part of the agreed list of tariffs for this option | Refer to benefits of your option. Go to "tools" on the website to access more information on your healthcare benefits Not paid |