Confinement fees repeated within 9 months???

Item: Gems (Government Employees Medical Scheme)
Rating: 1
Author: megbigood M

My c-section claim was rejected do to “confinement fees repeated within 9 months”. I have not had a baby within 9 months!!! What on earth is going on here ? I had to lay out so much money and I am desperate to be re-imbursed!

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Replies (2)

Gems (Government Employees Medical Scheme)'s replyOfficial

04 Feb 2019, 13:08

Good day

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

Kind regards
The GEMS online team

Gems (Government Employees Medical Scheme)'s reply04 Feb 2019, 13:08

Official

Good day

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

Kind regards
The GEMS online team

Gems (Government Employees Medical Scheme)'s replyOfficial

12 Feb 2019, 10:05

Good day

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

Please note that the authorisation for Dr Henriette van Zyl (gynaecologist) was initially rejected as “Confinement fees repeated within 9 months” due to Dr Caroline Gardiner (anaesthetist) billing the same codes.

The claim has been reprocessed and will be settled with the next claims run on 15 February 2019 as a refund to the member.

We apologise for any inconvenience caused.

Yours in service,

The GEMS Online Team

Gems (Government Employees Medical Scheme)'s reply12 Feb 2019, 10:05