LL
Lebo L

1 reviews | Active since Jan 2018

05 Feb 2019, 09:02

Authorisation horrible

I don't know if this would help. Because I've tried everything. Gems medical is a **** and a reminder that after all its a government institution. I have been calling g since the 23rd of January no help. My son was kicked out of hospital because gems had suspended him abd an investigation had to be done. I was told on the 29th I'd get feedback.... Nothing in stead I was told it was loved to the fourth of Feb I called yesterday... Nothing. So I called today only to be told that the turnaround time has been moved to the 7th. When I ask why... They don't know. Authorisation department also doesn't know. I've requested to speak to a manager. I have been placed on hold thrice and I'm still yet to speak to one. I've had my calls dropped. This is a moment of emergency. My son is jot in a good condition. And I'd think seeing that I'm paying every moth I'd get the service I deserve. I hate this medical aid. It's been a nightmare!!!!

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Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply05 Feb 2019, 10:01
Official
Good day

Thank you for affording us the opportunity to respond. We are looking into this and will provide feedback. 

Kind regards
The GEMS online team
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply12 Feb 2019, 10:05
Official
Good day Thank you for affording GEMS the opportunity to respond to your concerns regarding your authorisation. Please note that the authorisation requested for services rendered from 20 - 22 January 2019 was pended due to possible non-disclosure. The case was referred to the underwriters for further investigation. The underwriters has however confirmed that the dependant has not been treated for this condition before and the authorisation was therefore approved.Please be advised that this will not be the case with all authorisation requests, this is the procedure on certain conditions for new members/dependants. The account was processed and will be settled with the next claims run 15 February 2019.
We apologise for any inconvenience caused.  Yours in service, The GEMS Online Team