Active since Mar 2024
How do I get hold of you to cancel the medical aid.Phonecalls take 25 to 30 minutes to be answered.Emails are on generic "we will respond in 3-5 working days".This is unfair business practice paying R4600 to a company that seems to exist on paper only.One thing for sure,if i do not get a response i will block this month's debit order from the bank.Your scheme is run by ****mers
If you are an employee of Momentum Tyb(Ltd) and Sisonke Health Medical Scheme,you got paid salaries+ bonuses in December 2025 and a salary in January 2026,have a moment of silence for Healthcare Providers and their families because they have not had claims paid. The members have confirmed that Sisonke Medical Scheme still exists because they debited their monthly premiums in January 2026 and Momentum Tyb is still administrating for Sisonke Health Medical Scheme because when I phoned their PE offices i was given all sorts of excuses as to why claims were not paid.From blaming EDI etc.When this did not make sense i requested to speak to the team leader(Karen) who was the one advising the front desk lady,i was told that all of the sudden she was not available.So much for Accountability!Momentum Pty (Ltd) why are you playing mind games with our businesses?What is really going on between your business and Sisonke Health Medical Scheme? Credible administrators i.e Medscheme sent out notifications to explain why claims were not paid from the 1-19 January 2026 and true to their communication claims were settled on the 20January 2026.Your company does the duck and diving instead of being accountable. Some specialists report 0claims being paid for 2026,1GP despite submitting more than 15 claims in January got paid for 1X claim of December 2025 in January 2026 and my business has more than 50 claims for January 2026 not paid and EDI have submitted them a long time ago. Has the amalgamation between Sisonke Health Medical Scheme and Lonmin Medical Scheme affected the services provided by Momentum Tyb like payments of claims.Even so the communication with their claims dept did not suggest so.
Umvuzo pays claims haphazardly and erratically making us as healthcare workers deurmekaar and leaving our poor accountants frustrated!That is why we involve lawyers because it is exhausting getting a long statement documenting 2claims that were paid previously while there are outstanding claims that are not processed or dividing a claim of 1× patient by paying for consultation this week and pay for "some"medications the following week or the worst is not communicate the fact that you are experiencing challenges with processing claims but bar the receptionists from transferring enquiries to the claims department!Which year are we in 1900?? If you outsource processing of claims to a 3rd party and they are clearly overwhelmed; there are complaints about not meeting deadlines that were set by your company,micro management where claims are rejected without proper explanations and on top of all of these there is no communication and no accountability.Why risk losing business instead of getting rid of the service provider that does not fit in with the culture of your business? I was so suprised because Medshield sent an entire,time specific email explaining why their claims are not .processed It would be sad to see you lose clients because on paper your scheme offers competetive plans but let that translate into actions because no doctor wants to work with lawyers especially where patients are involved.
I have been a member of this scheme when it was still called Hosmed and i can safely say BEE has destroyed it.In the recent 2years i have contributed R107 232, with only 3GP consultations in 2025 and am deeply dissapointed with the dishonesty and ********* practices.I was sent claims statements showing that my GP was paid and they even provide dates,which turned out to be lies!!The poor doctor even showed me his banking app and on those days there are no payments from the ******.From 107 232 this scheme could not pay the doctor around R900.I had sciatica pain in December and not even one medication prescribed was covered.In this economy do you know how much that R107 232 could have made my life easy?How do you allocate R800 for spectacle frames+lenses?Today this abusive relationship is ending.I am joining Bestmed.
Sarah N**** receives the practice banking update forms and does not even forward them to the relevant dept however thanks us for sending the forms to her email,lol!Now you would think that this issue would be escalated,not at UMVUZO.We are still recovering from the shock but the practice would like to acknowledge and thank Thokozani M because we wanted to raise this matter with the unions at the mine.It's unacceptable to have claims not reimbursed for 2months when they are submitted to you in real time.
If there was a lower rating i would give, this med aid deserves it.In the era of 4IR they still give deadlines of 21days just to update details.SHOCKING but not suprising because all their reviews are negative.Municipal workers deserve better
It takes a long time to confirm banking details to pay claims and even longer for doctors's claims to actually be paid!
Claims are submitted everyday in realtime,but it takes this scheme more than 3months to pay them.Even then they do not pay the claims in full!!!
How many times do i have to submit banking details from my email address so that you can settle the claims?My consultant sent the details you said it needs to be from the business address,i did that but still you pay for the services that i have provided to your patients into their bank accounts,how does this work?I have NEVER registered my practice to be a cash practice.I would have submitted the claim directly to the patient if i was running a cash practice.How do you expect me to recuperate the money from a client of yours who consulted my practice once because he stays plus 100 of kilometres away!I do not get the logic of sending the remmitance statements to my practice because in essence you have paid the money to your clients for consulting me!I did not expect this from you Discovery,sooooo dissapointed!!
Why does it take more than a month to register doctors's practices?This process is supposed to take 48hours for you to acknowledge receipt of documents.Claims were submitted in February however the inefficiency in the registration processes is delaying payments.I understand that you have only had a meeting with SAdocs representatives after a month of submitting the documents(12/03/2024) even then the response is not satisfactory.How does it happen that hand delivered documents to your branch office end up not being sent to your main office for more than a month?
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