PS
Priyanka S

1 reviews | Active since Oct 2015

06 Oct 2023, 10:10

CLAIM KEEPS ASKING ME TO RESUBMIT

I am so frustrated with GEMS medical aid - that I am thinking of losing out on my government subsidy and switching to my husbands medical aid. I am on GEMS maternity benefit and my gynae requested that I do an NIPT scan at a private lab. It needed to be done immediately so I could not wait for medical aid approval. I filled in the PMB form and the tests were approved. I sent through a claim on 13 August, it was not processed by 29 August. I called to find out what is the problem and they informed me I needed to submit the proof of payment. I did submit the proof of payment on that same day. The claim was not processed. I called again, and the call centre lady said, according to the scheme the referring Dr practice number was not on the invoice sent through, so I got a new invoice with the referring doctor practice number CLEARLY stated. I then received an email saying I need to resubmit with the the referring Dr practice number. I called again today, and they said the claims department is busy. Honestly, I am at my wits end. I dont know what to do anymore. I think that this scheme has horrible customer service and offer NO coherent help. I am so disappointed that this is how they treat expectant mothers with NO care or consideration. They just create added stress and a heavier burden for us to be doing all of this administration.

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