GMES IS NOT PROCEESING MY DOCTORS CLAIM THAT WAS ALREADY AUTHORISED

<p>I WAS ADDMITTED TO DAYMED PRIVATE HOSPITAL ON 01/03/2017. I GOT AN AUTHORISATION NUMBER FROM GEMS FOR THE 01/03/2017 TO 02/03/2017(ONE DAY ONLY). MY MEDICAL AID NUMBER IS: ********** 88. AUTHORISATION NUMBER: ********** 4. IT WAS IN-HOSPITAL. ALL THE DOCTORS AND WHOEVER WAS INVOLVED WAS PAID OUT. THE AUTHORISATION WAS ALSO SPECIFICALLY FOR DR K REDDY WHO TILL DATE DID NOT GET PAID OUT. IT HAS BEEN A LONG BATTLE WITH GEMS, THEY STILL HAVE NOT PAID DR K REDDY DESPITE THE FACT THAT THE AUTHORISATION IS SPECIFICALLY AUTHORISED FOR DR K REDDY AND DR P SINGH, I HAVE ON SEVERAL OCCASSIONS SUBMIITTED THE DOCTORS STATEMENTS, EVEN WHEN GEMS PEOPLE CAME TO MY DEPARTMENT (WHERE I WORK), WHERE THEY PERSONALLY TOOK THE COPIES OF THE CLAIM STATEMENTS AND THE AUTHORISATION COPY. THEY PAID OUT DR P SINGH BUT NOT DR K REDDY. I PHONED BERYL DEPARTMENT WITH REFERENCE:</p> <p>100417Q1ZHLX</p> <p>180417Q24MX3</p> <p>120517Q2JNHD</p> <p>170517Q2L4H7</p> <p>170517Q2LD1</p> <p> </p> <p>AND REFERENCE NUMBER FOR CLAIMS DEPARTMENT:</p> <p> </p> <p>MH ********** 97</p> <p>MH ********** 49</p> <p>MH ********** 1</p> <p>MH ********** 2</p> <p>MH ********** 1</p> <p>MH ********** 1</p> <p>MH ********** 1</p> <p>MH ********** 4</p> <p>MH ********** 4</p> <p> </p> <p> </p> <p>I GOT NO ASSISTANCE, THEY KEEP SAYING IT IS IN THE CLAIMS BACK OFFICE OR IT IS NOT ACTIONED OR THAT THE BERYL DEPARTMENT NEVER GAVE THE INSTRUCTION AS YET FOR THE PAYMENT INSTRUCTION AND IT IS PUT ON HOLD. IT'S PAST THE TIME FOR THE CLAIM AND GEMS IS NOT GIVING ME THE REASON AS TO WHY THEY ARE NOT PROCESSING THE CLAIM YET THERE IS AN AUTHORISATION FOR IT. DR K REDDY'S OFFICE ALSO CALLED GEMS AND THEY TOLD THEM A DIFFERENT STORY THAT THE CODES WERE NOT CAPTURED. AT CLAIMS DEPT. BUT BERYL SAID THEY SENT IT FOR PROCESSING TO CLAIMS DEPT AND THEY ACCELARATED THE CLAIM - BUT IT IS SITTING LIKE AN EGG WAITING TO HATCH SOME WHERE IN GEMS OFFICES AND I THINK SOON THIS WILL BE A ROTTEN EGG!</p> <p> </p> <p>I AM GETTING SO FRUSTRATED AS IT IS GETTING ALMOST THREE FROM DATE OF SERVICE AND 1 1/2 MONTHS FROM DATE OF AUTHORISATION. TIME IS RUNNING OUT FOR THE CLAIM AND IT IS NOT MY FAULT THAT GEMS IS DELAYED ACTION.</p> <p> </p> <p> </p> <p>PLEASDE INVESTIGATE WHY GEMS IS TAKING SO VERY LONG WITH THIS CLAIM AND PLEASE TELL THEM TO ACCELARATE AND HURRY UP WITH THE CLAIM AND PAY DR. K REDDY OUT SOON. THIS IS JUST NOT FAIR WHAT GEMS IS DOING TO ME AS A MEMBER AND TO DR K REDDY AS HE RENDERED HIS SERVICES UNDER AUTHORISATION FROM GEMS.</p>