Metropolitan Medical Scheme ceases to Exist

Dear Healthcare Provider
 
Metropolitan Medical Scheme incorporation into Momentum Health
 
We are pleased to announce that the Council for Medical Schemes has approved the incorporation of Metropolitan Medical Scheme into Momentum Health, effective 1 July 2017. This communication serves to inform you, our healthcare partner, of the processes that would apply.
 
Metropolitan Medical Scheme will cease to exist from 1 July 2017 and its members will be issued with Momentum Health membership numbers.
 
Please remember to request their membership cards and to update your records, as well as to confirm their provider choice, especially where use of designated service providers apply. Momentum Health scheme rules, benefits and designated provider networks will apply as per the member Claims and any enquiries for dates of service prior to 1 July 2017 will need to be sent to Metropolitan Medical Scheme.
 
Thereafter, normal Momentum Health processes will apply in the routing of claims and enquiries.
 
Members will need to re-register for chronic medicine and other disease management programmes, such as renal and oncology, and benefits will be accorded as per Momentum Health scheme rules and benefits.
 
Please contact the call centre on 0860 11 78 59 to confirm registration for patients on existing programmes and availability of benefits.
 
Below is an easy reference to facilitate registration and submission of information for disease management programmes:
We look forward to welcoming Metropolitan Medical Scheme members on board and trust that the transition will be a seamless process.
 
SAB change of administrator
This communication serves to inform you of the SA Breweries Medical Aid MMI Health will continue to provide a claims and enquiry service in July (only), for claims incurred prior to 01 July 2017. Please ensure that these are received by MMI Health no later than 26 July to avoid delays.
 
Other than the above, all other matters pertaining to SAB Medical Aid claims, membership, and authorisation requests originating prior to and after 1 July 2017 will need to be directed to Discovery Health.

All authorisations issued by MMI Health will end on 30 June 2017 on the MMI Health system and the new administrator is to be contacted for continuation thereof.

 
These authorisations will, however, be migrated and loaded on the Discovery Health system. The email addresses and contact numbers for South African Breweries Medical Scheme remain unchanged.
 
Therefore for any changes to authorisations or for new authorisations after 30 June 2017, please contact the new administrator using the existing Scheme contact numbers or contact the Discovery Health provider call center directly.
 
Regards

MMI Health Provider Relations



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