MH
Monique H
1 reviews | Active since Oct 2018
21 Jun 2025, 11:57
Maternity
I went to the OB for my pregnancy on the 27 May. On the 9 June the dr uploaded the statement. I have phoned gems on the 9 June *** and emailed complaints on the same day ref: MH (GENCOM-575033). My OB visit went off my day to day which is suppose to go off my maternity high risk benefits and they have rejected my scan where I have scans left. The turn around time is 7 days. And we are past the 7 days. On the 30 June I need to see the OB again and this problem is still not resolved as I have asked it needs to be corrected before then.
Helpful (0)
Replies (3)0
Replies (3)
Gems (Government Employees Medical Scheme)'s replyOfficial
23 Jun 2025, 12:42Good 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 receive your positive feedback.
Regards,
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 receive your positive feedback.
Regards,
GEMS
Gems (Government Employees Medical Scheme)'s reply23 Jun 2025, 12:42
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 receive your positive feedback.
Regards,
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 receive your positive feedback.
Regards,
GEMS
MH
Monique H's updateReviewer Update
02 Jul 2025, 00:15This is veruly dissapointing. From the 9 June up to now my issue is not resolved. Dont gove out maternity high risk benefits if you guys are too *********** to do it correctly. My OB is still under my day to day. My scan is still rejected and no one is helping or giving feedback. PMB said after the 21 May when I have phoned I can use the ICD 10 code O34.3. It is almost a month trying to resolve this issue. So clearly my day to day will be exhausted as there os no cooperation from gems side. I have phoned 3 times. Send numerous emails. Very patetic.
MH
Monique H's update02 Jul 2025, 00:15
Reviewer Update
This is veruly dissapointing. From the 9 June up to now my issue is not resolved. Dont gove out maternity high risk benefits if you guys are too *********** to do it correctly. My OB is still under my day to day. My scan is still rejected and no one is helping or giving feedback. PMB said after the 21 May when I have phoned I can use the ICD 10 code O34.3. It is almost a month trying to resolve this issue. So clearly my day to day will be exhausted as there os no cooperation from gems side. I have phoned 3 times. Send numerous emails. Very patetic.
MH
Monique H's updateReviewer Update
02 Jul 2025, 21:04Okay so now the claim of the 27 May was reversed and added again with the incorrect ICD 10 code. I DO NOT HAVE A NORMAL PREGNANCY. I HAVE A HIGH RISK PREGNANCY FOR HIGH CHOLESTEROL NOW YOU ARE USING THE ICD 10 CODE Z34.9. DO YOU NOT HAVE MY INFORMATION INFRONT OF YOU TO SEE I DO NOT HAVE A NORMAL PREGNANCY AND THAT ICD 10 CODE IS NOT BEING USED??? THIS NEEDS TO BE FIXED WITHPUT AMY WAIITMG PEROID AS I HAVE BEEN WAITING SINCE THE 9 JUNE. MY SCAN IS ALSO STILL REJECTED. I AM BUSY LOSING MY **** WITH YOU GUYS. THE DOCTOR IS ON MY NECK TO PAY THE SCAN BECAUSE YOU GUYS KEEP IN REJECTING THE SCAN WHERE YOU GAVE ME 4 SCANS AND THE TARRIF CODES. IS THIS GOING TO TAKE A MONTH AGAIN TO FIX THIS WHICH IS NOT ACCEPTABLE????
GO ONTO MY INFORMATION AND FAMI****ISE YOURSELF WITH MY HIGH RISK PREGNANCY CAREPLAN AND FIX IT ASAP. THE ICD 10 CODE IS NOT CORRECT AND WHILE YOU ARE FIXING IT MAKE SURE IT DOES NOT GO OFF MY DAY TO DAY AND THAT MY SCAN IS ACCEPTED. I CAN NOT BELIEVE HOW PATHETIC AND USELESS THIS SERVICE AND HIGH RISK MATERNITY CAREPLAN IS AND THAT YOU GUYS CANT SEE WHAT HIGH RISK PREGNANCY CAREPLAN I AM ON. I HAVE BEEN WAITING WAY TOO LONG NOW AND EVERY MONTH I NEED TO CALL AND ASKED TO BE FIXED AND SCANS TO BE ACCEPTED. WHY DO I NEED TO CHECK UP IF YOU GUYS ARE DOING YOUR WORK CORRECTLY????
DO YOURSELF A FAVOUR AND APPOINT PEOPLE WHO CAN AND WANT TO DO THEIR WORK. NOW I HAVE HAD ENOUGH MORE THEN ENOUGH. THERE IS ANOTHER CLAIM COMING FOR THE 30 JUNE 2025 AND I AM SURE IM GOING TO HAVE THE SAME PROBLEM LIKE I HAVE BEEN HAVING FOR THE LAST 8 MONTHS. THE 21 JULY ANOTHER CLAIM IS COMING AND AGAIN THE SAME PROBLEM. THIS IS SHOCKING AND REALLY WORRYING. THAT YOU DO NOT EVEN KNOW THE ICD10 FOR HIGH RISK PREGNANCY IS NOT THE SAME AS THE ICD 10 CODE FOR NORMAL PREGNANCY YET YOU WANT TO USE THE NORMAL PREGNANCY CODE.
GO ONTO MY INFORMATION AND FAMI****ISE YOURSELF WITH MY HIGH RISK PREGNANCY CAREPLAN AND FIX IT ASAP. THE ICD 10 CODE IS NOT CORRECT AND WHILE YOU ARE FIXING IT MAKE SURE IT DOES NOT GO OFF MY DAY TO DAY AND THAT MY SCAN IS ACCEPTED. I CAN NOT BELIEVE HOW PATHETIC AND USELESS THIS SERVICE AND HIGH RISK MATERNITY CAREPLAN IS AND THAT YOU GUYS CANT SEE WHAT HIGH RISK PREGNANCY CAREPLAN I AM ON. I HAVE BEEN WAITING WAY TOO LONG NOW AND EVERY MONTH I NEED TO CALL AND ASKED TO BE FIXED AND SCANS TO BE ACCEPTED. WHY DO I NEED TO CHECK UP IF YOU GUYS ARE DOING YOUR WORK CORRECTLY????
DO YOURSELF A FAVOUR AND APPOINT PEOPLE WHO CAN AND WANT TO DO THEIR WORK. NOW I HAVE HAD ENOUGH MORE THEN ENOUGH. THERE IS ANOTHER CLAIM COMING FOR THE 30 JUNE 2025 AND I AM SURE IM GOING TO HAVE THE SAME PROBLEM LIKE I HAVE BEEN HAVING FOR THE LAST 8 MONTHS. THE 21 JULY ANOTHER CLAIM IS COMING AND AGAIN THE SAME PROBLEM. THIS IS SHOCKING AND REALLY WORRYING. THAT YOU DO NOT EVEN KNOW THE ICD10 FOR HIGH RISK PREGNANCY IS NOT THE SAME AS THE ICD 10 CODE FOR NORMAL PREGNANCY YET YOU WANT TO USE THE NORMAL PREGNANCY CODE.
MH
Monique H's update02 Jul 2025, 21:04
Reviewer Update
Okay so now the claim of the 27 May was reversed and added again with the incorrect ICD 10 code. I DO NOT HAVE A NORMAL PREGNANCY. I HAVE A HIGH RISK PREGNANCY FOR HIGH CHOLESTEROL NOW YOU ARE USING THE ICD 10 CODE Z34.9. DO YOU NOT HAVE MY INFORMATION INFRONT OF YOU TO SEE I DO NOT HAVE A NORMAL PREGNANCY AND THAT ICD 10 CODE IS NOT BEING USED??? THIS NEEDS TO BE FIXED WITHPUT AMY WAIITMG PEROID AS I HAVE BEEN WAITING SINCE THE 9 JUNE. MY SCAN IS ALSO STILL REJECTED. I AM BUSY LOSING MY **** WITH YOU GUYS. THE DOCTOR IS ON MY NECK TO PAY THE SCAN BECAUSE YOU GUYS KEEP IN REJECTING THE SCAN WHERE YOU GAVE ME 4 SCANS AND THE TARRIF CODES. IS THIS GOING TO TAKE A MONTH AGAIN TO FIX THIS WHICH IS NOT ACCEPTABLE????
GO ONTO MY INFORMATION AND FAMI****ISE YOURSELF WITH MY HIGH RISK PREGNANCY CAREPLAN AND FIX IT ASAP. THE ICD 10 CODE IS NOT CORRECT AND WHILE YOU ARE FIXING IT MAKE SURE IT DOES NOT GO OFF MY DAY TO DAY AND THAT MY SCAN IS ACCEPTED. I CAN NOT BELIEVE HOW PATHETIC AND USELESS THIS SERVICE AND HIGH RISK MATERNITY CAREPLAN IS AND THAT YOU GUYS CANT SEE WHAT HIGH RISK PREGNANCY CAREPLAN I AM ON. I HAVE BEEN WAITING WAY TOO LONG NOW AND EVERY MONTH I NEED TO CALL AND ASKED TO BE FIXED AND SCANS TO BE ACCEPTED. WHY DO I NEED TO CHECK UP IF YOU GUYS ARE DOING YOUR WORK CORRECTLY????
DO YOURSELF A FAVOUR AND APPOINT PEOPLE WHO CAN AND WANT TO DO THEIR WORK. NOW I HAVE HAD ENOUGH MORE THEN ENOUGH. THERE IS ANOTHER CLAIM COMING FOR THE 30 JUNE 2025 AND I AM SURE IM GOING TO HAVE THE SAME PROBLEM LIKE I HAVE BEEN HAVING FOR THE LAST 8 MONTHS. THE 21 JULY ANOTHER CLAIM IS COMING AND AGAIN THE SAME PROBLEM. THIS IS SHOCKING AND REALLY WORRYING. THAT YOU DO NOT EVEN KNOW THE ICD10 FOR HIGH RISK PREGNANCY IS NOT THE SAME AS THE ICD 10 CODE FOR NORMAL PREGNANCY YET YOU WANT TO USE THE NORMAL PREGNANCY CODE.
GO ONTO MY INFORMATION AND FAMI****ISE YOURSELF WITH MY HIGH RISK PREGNANCY CAREPLAN AND FIX IT ASAP. THE ICD 10 CODE IS NOT CORRECT AND WHILE YOU ARE FIXING IT MAKE SURE IT DOES NOT GO OFF MY DAY TO DAY AND THAT MY SCAN IS ACCEPTED. I CAN NOT BELIEVE HOW PATHETIC AND USELESS THIS SERVICE AND HIGH RISK MATERNITY CAREPLAN IS AND THAT YOU GUYS CANT SEE WHAT HIGH RISK PREGNANCY CAREPLAN I AM ON. I HAVE BEEN WAITING WAY TOO LONG NOW AND EVERY MONTH I NEED TO CALL AND ASKED TO BE FIXED AND SCANS TO BE ACCEPTED. WHY DO I NEED TO CHECK UP IF YOU GUYS ARE DOING YOUR WORK CORRECTLY????
DO YOURSELF A FAVOUR AND APPOINT PEOPLE WHO CAN AND WANT TO DO THEIR WORK. NOW I HAVE HAD ENOUGH MORE THEN ENOUGH. THERE IS ANOTHER CLAIM COMING FOR THE 30 JUNE 2025 AND I AM SURE IM GOING TO HAVE THE SAME PROBLEM LIKE I HAVE BEEN HAVING FOR THE LAST 8 MONTHS. THE 21 JULY ANOTHER CLAIM IS COMING AND AGAIN THE SAME PROBLEM. THIS IS SHOCKING AND REALLY WORRYING. THAT YOU DO NOT EVEN KNOW THE ICD10 FOR HIGH RISK PREGNANCY IS NOT THE SAME AS THE ICD 10 CODE FOR NORMAL PREGNANCY YET YOU WANT TO USE THE NORMAL PREGNANCY CODE.