Moto Health Care
Not again

I have just received an answer to my complaint from Thamie Magula. It states that the claim can not be paid because of no pre-authorisation. The treatment that was paid was on the authorisation of the letter we received on the 15/12/12 dated 10/12/12. But this letters authorisation does not cover treatment in 2013 but only 2012. As four visits to the dentist was required to complete these treatments, why did they not realise this and reissue another letter for 2013. What Moto Health are now saying is that a large percentage of authorisations posted in the last two or three weeks of Dec. 2012 are invalid for all members who could not complete their treatments before the new year. Do thay not realise this is the Christmas period and getting all my treatments fitted in before the new year was impossible.
Not withstanding the above, I have read through the rules and can find no such rule that states authorisation given in 2012 is not valid for 2013. This would mean any and all authorisations posted the last weeks of Dec. would never reach the members until after the new year and be invalid.
You are just sucking things out of the air to delay the payment of this claim.

Company: Moto Health Care
Country: South Africa
City: Durban

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