1 reviews | Active since Aug 2012
Billing
<p>I received an e-mail regading bloods that were rejected due to the incorrect code used the code is z34.9. I'm currently on the Maternity program and was advised my bloods will be processed when I registered with these programs. In February I sent an email and I received a call . The code used for discription is z10 but it also clearly state that the invoice is referring to code 34,9. This hasn't been sorted out as I still get a bill from Dietrich Bruce E Street and Pertners. Got an email today 14/03/17 the guy from clams said it was a "general code that was used that's why they were not paid " I got cut off. Can this issue please be sorted out because two people cannot tell me the same thing and all of a sudden there is no claim. This is causing huge stress as I'm on high risk pregrency. Gems refuse to pay this bill and it is dated October 16 already, maybe the want the claim to go stail</p>
Good day
Thank you for affording GEMS the opportunity to respond to your concerns. We are looking into this matter and will respond soonest.
Kind regards
The GEMS online team
Good day
Thank you for affording GEMS the opportunity to respond to your concerns. We are looking into this matter and will respond soonest.
Kind regards
The GEMS online team
Still no reply from gems, we are awaiting payment on this still, or a call from gems atleast
Still no reply from gems, we are awaiting payment on this still, or a call from gems atleast
Good day
Thank you for bringing your claim concerns to our attention.
As explained by the Scheme please be advised that pathology accounts could not be reviewed for payment from the maternity benefit as the ICD-10 code quoted on the accounts does not correspond with the authorised ICD-10 codes as per the GEMS maternity programme benefit.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
As explained by the Scheme please be advised that pathology accounts could not be reviewed for payment from the maternity benefit as the ICD-10 code quoted on the accounts does not correspond with the authorised ICD-10 codes as per the GEMS maternity programme benefit.
Kind regards
The GEMS online team
On the statement it clearly state icd z34.9, is this not the code that should be used. And why was this not highlighted with pathcare
On the statement it clearly state icd z34.9, is this not the code that should be used. And why was this not highlighted with pathcare
Good day
Thank you for alerting us to your claim concerns.
As indicated the account was submitted electronically by the service provider with the ICD-10 code as Z01.7. Please note that the information received cannot be changed or amended by the Scheme and that we will require an amended claim, reflecting the correct ICD-10 code, from the healthcare service provider.
We trust that this is in order.
Kind regards
The GEMS online team
Good day
Thank you for alerting us to your claim concerns.
As indicated the account was submitted electronically by the service provider with the ICD-10 code as Z01.7. Please note that the information received cannot be changed or amended by the Scheme and that we will require an amended claim, reflecting the correct ICD-10 code, from the healthcare service provider.
We trust that this is in order.
Kind regards
The GEMS online team
The code is clearly Z34.9 , and pathcare has been in contact with you regarding this, strange for pathcare to make this mistake (would think they would want there money) worst medical aid.
The code is clearly Z34.9 , and pathcare has been in contact with you regarding this, strange for pathcare to make this mistake (would think they would want there money) worst medical aid.
Pathcare reply, medial aid paid monthly and this is the **** service you get
Dear Ms. Pieterse
As discussed and further to our telecom, all information supp**** to us by your referring doctor is correct.
However, the claims were rejected due to incorrect processing by the medical aid, and through no fault of PathCare, as we supp**** the correct ICD10 code.
We have since followed through with medical aid on your behalf, further to your resubmission of the claims.
We trust that the accounts will be settled accordingly.
Assuring you of our best intentions at all times.
Yours sincerely,
Sharon van der Berg
PathCare Debtors
Pathcare reply, medial aid paid monthly and this is the **** service you get
Dear Ms. Pieterse
As discussed and further to our telecom, all information supp**** to us by your referring doctor is correct.
However, the claims were rejected due to incorrect processing by the medical aid, and through no fault of PathCare, as we supp**** the correct ICD10 code.
We have since followed through with medical aid on your behalf, further to your resubmission of the claims.
We trust that the accounts will be settled accordingly.
Assuring you of our best intentions at all times.
Yours sincerely,
Sharon van der Berg
PathCare Debtors
Good day
Please be advised that the account is, unfortunately, stale.
If you are able to provide us with proof that the account was submitted to GEMS within the four month claiming period, we will do our level best to assist you.
We apologise for any inconvenience caused in this regard.
Kind regards
The GEMS online team
Good day
Please be advised that the account is, unfortunately, stale.
If you are able to provide us with proof that the account was submitted to GEMS within the four month claiming period, we will do our level best to assist you.
We apologise for any inconvenience caused in this regard.
Kind regards
The GEMS online team
Are you stupid, scroll up and see youre acknowledgement , no proper communication within gems, I am escalating this with the medical ombudsman as gems staff are ***********.
Are you stupid, scroll up and see youre acknowledgement , no proper communication within gems, I am escalating this with the medical ombudsman as gems staff are ***********.