1 reviews | Active since May 2016
Contemptable service provided by Gems, on so many levels
<p>Gems has been nothing but a headache during my pregnancy. They claim to make pregnancy less stressful through their maternity programme yet do nothing but exacerbate an already pressured period. </p> <p>Below is a brief description of some of their failures.</p> <p>Ranging from inadequate reimbur*****t of cash payments made during the pregnancy to now almost three months post delivery a non payment of the gynae fees</p> <p>Delayed payments to the paediatrician where the claim had to be repeatedly made despite the fact that the newborn was registered on the medical scheme within less than two weeks of her birth</p> <p>No response was made to a claim for reimbur*****t of cash paid to the paediatrician now more than a month following the claim</p> <p>No response to my query for a statement regarding reimbur*****t rates where I paid an upfront fee of R5000 to my gynae for delivery and was re imbursed an amount less than R1000 without explanation.</p> <p> </p> <p>I have forwarded a more detailed description to gems of my complaints on 5/5/16 and to date have not received ANY response.</p> <p>I cannot describe the frustration, anger and extreme stress that this lack of courtesy has caused. It is utterly disgraceful that such a large corporation, endorsed by the government is able to behave in such an unprofessional manner and unashamedly so.</p> <p> </p> <p> </p> <p> </p> <p> </p>
Good day
Thank you for bringing your concerns to our attention. We are terribly sorry that you have been experiencing difficulties. We are attending to your complaint and we will provide feedback as soon as possible.
Kind regards
The GEMS online team
Good day
Thank you for bringing your concerns to our attention. We are terribly sorry that you have been experiencing difficulties. We are attending to your complaint and we will provide feedback as soon as possible.
Kind regards
The GEMS online team
Congratulations on the birth of your baby. Please accept our apologies for the delay in assisting you and for any inconvenience caused in the process.
Our records indicate that the accounts for services rendered on 22 February were paid on 11 March and 31 March respectively. There was however one tariff code under review, as this tariff code can only be charged in the event of an emergency. This tariff code has since been approved for payment.
The account for the services rendered on 21 February and 22 February were paid on 26 February, 29 April and 13 May respectively. The remaining account was paid on 3 June in accordance with Scheme rates.
Please note that as per the rules of the Scheme, all claims are paid at agreed rates and are at all times dependent on your available benefits. Please keep in mind that you will be responsible for paying the difference in the event that you choose to consult a healthcare service provider who charges more than the stipulated Scheme rates.
We trust that the above is in order.
Yours in service,
The GEMS Online Team
Congratulations on the birth of your baby. Please accept our apologies for the delay in assisting you and for any inconvenience caused in the process.
Our records indicate that the accounts for services rendered on 22 February were paid on 11 March and 31 March respectively. There was however one tariff code under review, as this tariff code can only be charged in the event of an emergency. This tariff code has since been approved for payment.
The account for the services rendered on 21 February and 22 February were paid on 26 February, 29 April and 13 May respectively. The remaining account was paid on 3 June in accordance with Scheme rates.
Please note that as per the rules of the Scheme, all claims are paid at agreed rates and are at all times dependent on your available benefits. Please keep in mind that you will be responsible for paying the difference in the event that you choose to consult a healthcare service provider who charges more than the stipulated Scheme rates.
We trust that the above is in order.
Yours in service,
The GEMS Online Team
Good day
I have received an account statement from the gynaecologists office mentioned above as well as telephonic assurance that the account has not been settled. Payments due to me have still not been processed due to petty requirements by gems which the account system at the service providers office does not allow. I am thus in the process of seeking legal advice for what I deem to be unjust processes. My maternity leave is drawing to a close and yet here I am wasting time and energy to resolve this issue.
Yours Sincerely
Mrs Jessica Fynn-Theys
Good day
I have received an account statement from the gynaecologists office mentioned above as well as telephonic assurance that the account has not been settled. Payments due to me have still not been processed due to petty requirements by gems which the account system at the service providers office does not allow. I am thus in the process of seeking legal advice for what I deem to be unjust processes. My maternity leave is drawing to a close and yet here I am wasting time and energy to resolve this issue.
Yours Sincerely
Mrs Jessica Fynn-Theys
Good day
Thank you for affording GEMS the opportunity to respond to your multiple claims query.
We can confirm that the accounts were paid directly to the service providers concerned. Each of the claims were settled at Scheme rates and in line with your available benefits. While we have paid the account the tariff code for the invoice dated 22 February 2016 (Dr Solomon) is under review as it appears that the incorrect code was used in this instance.
Please note that all claims are paid at the GEMS Scheme rate in accordance with Scheme Rules, member's available benefits and in line with clinical protocols.
In instances where the provider is charging more than the Scheme rate, the member is unfortunately responsible for paying the difference.
We apologise for the delay in processing the account and for any inconvenience caused in this regard. We trust the above is in order.
Yours in service,
The GEMS Online Team
Good day
Thank you for affording GEMS the opportunity to respond to your multiple claims query.
We can confirm that the accounts were paid directly to the service providers concerned. Each of the claims were settled at Scheme rates and in line with your available benefits. While we have paid the account the tariff code for the invoice dated 22 February 2016 (Dr Solomon) is under review as it appears that the incorrect code was used in this instance.
Please note that all claims are paid at the GEMS Scheme rate in accordance with Scheme Rules, member's available benefits and in line with clinical protocols.
In instances where the provider is charging more than the Scheme rate, the member is unfortunately responsible for paying the difference.
We apologise for the delay in processing the account and for any inconvenience caused in this regard. We trust the above is in order.
Yours in service,
The GEMS Online Team