Mamoth Health Medical Scheme
Mamoth Health Medical Scheme
Date: 27 Jan 2012
NEW MAMOTH HEALTH SCHEME INFORMATION
Mamoth Health, a self administered scheme, will be processing medicine claims via MediKredit with effect from 1 February
2012. New acute and chronic option codes as indicated in the summary table have been assigned for the processing of all
plans.
2. HEALTHNET
2.1 Claims:
a) Claims should be submitted via HealthNet
2.2 Validation:
HealthNet will validate:
a) Membership number
b) Date of birth
c) Dependent Code
2.3 Networks:
HealthNet will accommodate all networks as agreed to with the scheme.
2.4 Mark‐up & Dispensing Fee
a) Schedule 0 and non‐scheduled items calculated on published wholesale price : R0 to R78.00: 34.20 %, Max R26.68 (Incl.
VAT)
b) Schedule 1 to 7 calculated on Single Exit Price: R0 to R78.00: 34.20 %, Max R26.68 (Incl. VAT)
2.5 Membership Number
a) Total length: 9 digits
2.6 Stale Claim Period
120 Days
2.7 On‐line Reversal Period
120 Days
3. PAYMENT INFORMATION
MediKredit will be paying providers on behalf of the scheme.
SUMMARY OF SCHEME RULES
PLAN/OPTION OPTION CODE SURCHARGE
MMAP/REF
PRICING or URP
MAMOTH HEALTH DD ACUTE MAHDA 612661 * Check HealthNet ST Response No
MAMOTH HEALTH DD CHRONIC MAHDC 612688 * Check HealthNet ST Response No
∗ The Fam‐ & Auth‐ check functionality will be available on these options.
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2012-05-29 @ 10:33 am
I need the contact number for Mamoth Health to obtain authorisation as well as the destination code where the claims are to be submitted to.
2013-09-07 @ 8:35 pm
Please contact me in connection of outstanding claims and also the e-mail adres for MAMOTH HEALTH.
THANK YOU FOR YOUR URGENT REPLY
SUSAN DERCKSEN
2013-09-09 @ 8:04 am
We would suggest that you contact Mamoth Health directly. You should have the telephone number from the back of the membership card that was presented at your rooms. All the best.
2016-05-06 @ 9:46 am
I need a email address for follow up on outstanding radiology accounts since January 2016. We are not able to get thru to your telephone nr 00266 22322383. This claim is long overdue and I need urgent feedback, otherwise the member will kept responsible to settle this account before end of May 2016. Thanks Hanna.
2016-05-09 @ 7:56 am
We are not the medical aid you are looking for.
2016-07-23 @ 9:27 am
Good Day,
I have EDI-ed and sent e – mails repeatedly to Mammoth Health Lesotho. Unfortunately we have had no response whatsoever. This has been since February 2016. We are not able to get through to your number 0026622322383. These are outstanding Speech Language and Feeding Therapy accounts for a patient seen in hospital. Kindly provide the correct e – mail address so that tyhe member will not be liable for the payments. The claim is long overdue and I need urgent feedback.