JO
Jody O

1 reviews | Active since Sept 2018

10 Dec 2025, 14:07

IMPOSSIBLE SERVICE FROM GEMS

I am writing as a provider for GEMS, I have claims that aren't being seen to, either they claim it is stale (which it isn't and i have proof of that) and now they no longer send an auto response form both email addresses *** and *** This is very concerning in being able to assist patients on GEMS. The call center also gives you the run around. The claim starts at the normal claims processing center, then if you require it to go for PMB review, you speak to the PMB department, but then when you need to follow up on the PMB you have to go back to the normal claims call center. It is highly confusing. I just spoke with a team leader Bulelani, he said i need to try email the *** again and give it 72hrs. I will do that and i will come back to update my review on this ongoing issue I have.

0
Replies (3)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply10 Dec 2025, 15:17
Official
Good day,

Thank you for engaging with us. We confirm receipt of your message and apologise for the delay in acknowledging your message.

If you have an urgent query, please contact us on: ***(members) & ***(providers).
 
 Call Centre Hours: Monday - Friday: 8h00 - 17h00 & Saturday: 8h00 - 12h00. Emergency number: ***(available 24 hours)
 
 If you wish to submit a compliment, please email us on at ***. We look forward to receiving your positive feedback. 
 
Regards,

GEMS


JO
Jody O's update10 Dec 2025, 15:19
Reviewer Update
Hi Gems,

I will revert back to you with a response when I have gotten back to Bulelani.

Regards,
Jody

JO
Jody O's update10 Dec 2025, 15:25
Reviewer Update
Thank you.