Evolve Option members who sustain a sports injury and require treatment are covered for two physiotherapy or biokineticist treatment sessions, up to a limit of R1 060 per year.
Members do not need a referral from a GP or doctor before using the benefit and claims are covered up to the Momentum Medical Scheme Rate.
How to pre-authorise for this benefit
Members can send us a WhatsApp message or call us on 0860 11 78 59 to request pre-authorisation.
Information we need for pre-authorisation:
- Details of how the injury occurred to confirm that it is a sports injury
- Practice number of the physiotherapist or biokineticist
- ICD-10 code
- Tariff codes
- Date of treatment
In the case where members do not have these details when contacting us:
- We will provide a reference number to confirm that they have cover once a sports injury is confirmed.
- We will ask members to obtain the outstanding details from the treating physiotherapist or biokineticist when they visit the provider.
- Once the member provides us with the outstanding information, we will confirm the authorisation number to facilitate payment of the claims.