CJ
Carol J

1 reviews | Active since Sept 2016

28 Jun 2017, 10:11

Bad Service - Failed to refund my Claim!Metropolitan Health Group Administrators

<p>On 21st January 2017,I submitted my claim to GEMS. I have proof of same together with the refund claim. I followed up with another email to no avail. On the 26th June 2017, I received an email from GEMS stating my query was now closed as I had not furnished them with the claim so they cannot action. This is absolute incompetence and shocking service. The stale claim period has now come and gone and it will take another couple of months no doubt to be paid as it will need to be approved. This delay is at my expense. Why on earth pay for an option that does not manage the claims efficiently.</p>

0
Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply28 Jun 2017, 10:42
Official

Good day

Thank you for affording GEMS the opportunity to respond to your concerns.

We are looking into this matter and will provide feedback.

Kind regards

The GEMS online team

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply05 Jul 2017, 13:15
Official

Good day

Thank you for bringing your concerns to our attention.

Please be advised that the ICD-10 code on the account submitted is regarded as a Scheme exclusion and therefore does not qualify for any benefits.

We trust the above is in order.

Kind regards

The GEMS online team