GEMS

Dear Sir

I cannot believe how poor is the service at GEMS. Either they do not understand a statement from a Specialist Maxillofacial or they do not want to understand.

I underwent surgery in my mouth during 2019. It started at 26 March 2019 and the last surgery was at the end of October. I paid the amount of R16 500-00. The problem started when I send in a claim for that amount.

Every time GEMS said they want a statement from the doctor. I send the statement at least 3 times and every time they say they do not understand the statement. The last time they said the statement is incomplete. I spoke to the doctors consulting rooms and according to the receptionist the statement is complete. I even attached my receipt.

Now suddenly GEMS is quiet. I do not hear from them, it is almost impossible to contact them via the telephone.

I do not understand what is the problem. All the detail is on the statement. The practice number of the doctor is their, the procedure code is their, description of procedure is their, ICD 10 is their and the tooth area. What more do they want? GEMS is a medical fund. I am sure they must understand the statement.

Really, GEMS is pathetic.

Thank you for your time.

Dries Marais