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GEMS TARIFFS ARE VAT INCLUSIVE Copy

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The schedule includes procedures and services for use by Oral Healthcare Providers for purposes of keeping accurate patient records, reporting procedures on patients, and processing oral healthcare related insurance claims. The procedures are those performed by general dental practitioners, oral pathologists, prosthodontists, periodontists, orthodontists, maxillo-facial and oral surgeons and dental therapists.

The procedures codes listed in the schedule have, for the convenience in using the schedule, been divided into categories of services, based on the branches of clinical dental practice. The procedures are grouped under the category of service with which the procedures are most frequently identified and should not be interpreted as excluding certain categories of Oral Healthcare Providers from performing such procedures. Individual procedure codes consist of a procedure code, procedure description (nomenclature), and when necessary, a descriptor, that provides further definition and/or guidelines to clarify the intended use of the procedure code.

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Momentum Dental Network | 2023 changes and fee structure

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January 2023

Dear Healthcare Provider

Momentum Dental Network | 2023 changes and fee structure

Thank you for being part of the Momentum Dental Network in 2022 and partnering with us in our drive to provide quality private healthcare to our members at an affordable price.

Please note the following important information for 2023:

Momentum Health Solutions Primary Care Dental Network merged with Fishmed Dental Network
Please note that the Fishmed Dental Network has been merged with the Momentum Health Solutions Primary Care Dental Network. The Fishmed benefits have been aligned to the Momentum Health Solutions Dental Network benefits and will take effect from 1 January 2023. Please familiarise yourself with the dental benefits in the link below as there have been significant changes to the Fishmed benefits.

The new participating medical scheme and benefit options can be found on the updated Annexure A – Participating schemes and health insurance products for 2023.

Scheme rates
Click here to view the dental network benefits and rates for 2023.

Personal protective equipment (PPE) funding

The dental PPE funding will be discontinued from 1 January 2023 and tariff code 8109 will revert to the original value on the increased amount for R23.70. We kindly request that you do not keep members liable for any costs relating to PPE.

Dental practitioner guide and online resources
For your convenience, we have created a Momentum Dental Network Guide for dental practitioners on our network. It will also be made available on the Momentum Health Solutions provider portal from 1 January 2023.

You also have access to the Momentum provider website where the following information can be found:
• Pay-run dates for 2023 per medical scheme under our administration
• Banking details form and process should you need to change your banking details
• Non-network dental rates for all medical schemes administered by Momentum Health Solutions.

Laboratory claims submission
Please share the network rates and codes with the laboratory you choose to make use of and advise them to make use of these codes should they bill directly.

Should you have any queries, you are welcome to contact us by email at drnet@momentum.co.za.

We would like to express our sincere thanks for your continued commitment and service to our valued members.

Kind regards

Provider Management
Momentum Health Solutions

 

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