HS
Hilgard S

1 reviews | Active since Jan 2011

11 Nov 2016, 16:49

GEMS decline authirization after op

<p>We got authrization from GEMS on 4 nov 2016. All codes approved. My wife goes into hospital for op on 7 nov with specialist.. The 8th they called and said there was one if codes wrong so they canceled whole autherization. That means no payment to anyone not even. Its the 11 today and the 'investigation' on their side is still no where. They do not return calls, like Tracy. We phone but nothing happens just get posted from pillar to post. Even the specialist phoned after GEMS spoke to a Duncan. This all having my wife in tears and stressed when she should be recovering. WORST SERVICE EVER. </p>

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Replies (3)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply14 Nov 2016, 09:56
Official

Good day

Thank you for alerting us to your authorisation queries.

We are investigating this and will provide feedback.

Kind regards

The GEMS online team

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply12 Dec 2016, 15:37
Official

Good day

Thank you for bringing your unpaid claim concerns to our attention.

We can confirm that the doctor's account for services rendered on 7 November 2016 has been accepted for payment and will be settled with the claims payment run on 16 December 2016.

Please accept our sincere apologies for the delay in resolving this matter.

Kind regards

The GEMS online team

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply12 Dec 2016, 15:37
Official

Good day

Thank you for bringing your unpaid claim concerns to our attention.

We can confirm that the doctor's account for services rendered on 7 November 2016 has been accepted for payment and will be settled with the claims payment run on 16 December 2016.

Please accept our sincere apologies for the delay in resolving this matter.

Kind regards

The GEMS online team