SB
Solani B

1 reviews | Active since Jul 2023

23 Jul 2023, 10:52

Disgusting Service,Claims not paid!

I have endured the most appalling,pathetic and disgusting service ever since I found out I was pregnant.I registered for their maternity plan on the day the GP confirmed my pregnancy.They promised that a midwife would be in touch within 48 hours,my daughter is now 3 months old and I’m yet to receive a call from the midwife.I paid for my pregnancy vitamins out of pocket because when I initially tried to puschase the at the pharmacy,I was told that gems says I’m not registered on the maternity program,which of course was not true,the second time,I was told that I need a prescription from my gynae,which I went and obtained,only to be told by the pharmacist that Gems says I have already given birth and am thus not a candidate for the vitamins.Mind you,I was evidently pregnant and they had recently confirmed by admission for delivery,which confirmation email,I showed to the pharmacy,who couldn’t do much as he went with the response he received. My Dr’s practice requires cash upfront,if you are a gems patient and they provide the necessary paperwork to enable you to claim back from the medical aid. I paid for my delivery upfront,I gave birth on 15/04/1023 and I was provided with a statement/invoice and receipt my the Dr. I submitted these on 19/04 and a few days later I was sent correspondence that they have rejected the claim as the pop was invalid. I informed the Dr’s PA of this and she tried to submit the claim on my behalf and would then transfer the funds to me once received.That claim was also rejected.I called their call centre numerous times,only to receive the most appalling service under the sun.They either hang up on you,keep you on hold forever,and one always feels that they can’t wait to end the call.They do not even try to go the extra mile to be of help,they are rude,abrupt and unprofessional.I have been to the Arcadia office a few times and still received no joy.I’m at my wits end as I need the money,I spent my maternity leave going back and forth with gems and I even asked the Dr to amend the receipt,but it’s still not good enough.I also sent my bank statement as proof of the transaction,still no joy.If it was not for the government subsidy,trust I would have changed medical aids ages ago!

What really gets to me is the fact that no one at gems cares enough to resolve this issue or at least make the customer experience bearable. I feel so helpless and I can’t leave my 3 month old to go stand in that long queue outside the Arcadia office everyday,I can’t!😡😡😡

0
Replies (0)