6 Months and still waiting for claim to be paid

<p>I am on the Beryl option at GEMS. I had to go to the medi clinic hospital for an emergency case as I fainted on the 16/12/2015. I phoned the very next day to GEMS to find out whether I needed pre-authorisation. The lady told me no, as it was an emergency I do not need a pre-authorisation. Two months down the line I got a bill from the hospital that I need to pay them as GEMS did not cover. I phoned GEMS and they told me because I did not get pre-authorisation within 48 hrs of the incident they will not be paying it - contrary to what the lady told me on the phone. Eventually it took weeks to get the pre-authorisation backdated. After the pre-authorisation got backdated, numerous times was this claim submitted for processing and still rejected. My pre-authorisation number is: ***7. I spoke to the below mentioned people, waiting for hours on the phone for them to resolve the matters. They cant even phone you back, if you tell them to resolve the matter and give you feedback. - Doreen - Ursula (team leader) - Audrey - Nambieta (Team leader) - Zanele - Lyle - Lerato - Rapdipha - Eunice - Nandipha - Robin I am still waiting for the claim to be paid and it is six months down the line. Ezmerelda was supposed to call me back today to give me feedback during lunch time, but she did not call me back yet. I would recommend no one to join gems as they pathetic and stupid working for them!!!! I was also at the Cape Town branch at numerous times but the matter is still unresolved.</p>