No Refunds from GEMS for purchase of Adult Diapers

Once again I am experiencing ********** service from the so called BACK OFFICE.

My mother is 82 years old. Had 2 strokes and requires adult diapers at this stage of life.

I have sent motivations, prescriptions and quotations for adult pull up diapers in March for approval. I received correspondence stating diapers were approved and that I can purchase them, and that there was no need to submit supporting documents. I have all correspondence.

I purchased the Adult diapers from Dischem and Clicks from March to date, once a month. Purchases safe on my credit card.

1. The so called BACK OFFICE staff utilized the funds from my dad to day savings depleting my savings account. Hence there are no funds fir mum to see her Specialists for her PMB conditions. Call Centre staff, are excellent they escalated thus. Adult diapers are meant to be paid from Surgical Aapluance Benefit, as per correspondence received from GEMS.

2. Call Centre Agents have informed me on numerous telecoms that adult diapers ate AUTO APPPROVED. I have the dates times and names if all Call centre agents I have spoken to.

3. I was told that Dischem and Clicks put incorrect tariff codes on the invoices fir April, May and June 2024. This is hilarious. My mum is dependent code 02 on invoices. GEMS BACK OFFICE STAFF feedback to call centre agents, was that Clicks and Dischem used incorrect tariff being 0020 which means MEDICATION EXCLUSION.......Are adult diapers MEDICATIONS....(I am perplexed at their stupidity) and lack if feedback informing me, on the outcome of escalations.

I was requested to go back to Dichem & Clicks and get new invoices with correct tariff code 0201 which means...MATERIALS. Clicks n Duschen cannot generate new invoices for April, May an June , so the pharmacists wrote the tariff codes on original invoices, signed and stamped the invoice. I re-submitted to GEMS FOR APPROVAL OF REFUNDS TO ME. The staff at Dischem & Clicks were shocked at the whole situation.

4. I call the Call Centre weekly from May 2924 to date. The Call Centre Agents are extremely helpful, and all confirm adult diapers are auto approved. They requested I resubmit all motivations, prescriptions quotes, corrected invoices with tariff code, and they escalated to their Team Leader and to the infamous *********** BACK OFFICE STAFF......Who are useless, unqualified individuals. Call Centre Agents cannot communicate with BACK OFFICE STAFF. They have to escalated to their Team Leaders, who supposedly have the ability or accessibility to the BACK OFFICE DEPT.

But no successful feedback after escalations spanning 6 weeks.

I received correspondence from GEMS again dated 16 July 24, approving adult pull up diapers, the covering letter has another members names, a male with hus membership number, but all my mums motivations, prescription fir diapers, invoice n quotation. This is how truly DUMB They are. I have no choice of a better adjective to describe these ***********. Unqualified BACK OFFICE STAFF. An investigation needs to undertaken into Thus so called BACK OFFICE TO INVESTIGATE THEIR DECISION MAKING PROCESS AND PROTOCOLS.

WHERE IS THIS BACK OFFICE DEPARTMENT LOCATED???...WHY ARE THEY INACCESSIBLE???. DO THEY HAVE MANAGERS TO OVERSEE DECISION MAKING, AND WORK FLOW OPERATIONS, OR QUALITY CONTROL ????DO THEY HAVE A COMPLAINTS RESOLUTION PROCESS???TURN AROUND TIME ????

NOTE THIS IS THE DEPARTMENT THAT APPROVES SURGICAL APPLIANCES e.g. wheelchairs, cushions, grab rails, commies, shower chairs etc etc. DIAPERS ARE LAID FOR FROM THIS BENEFIT.

DOES GEMS NOT WANT TO DO REFUNDS FOR ADULT DIAPERS.

FOR AN ADULT TO WEAR A DIAPER IS THE MOST HUMILIATING PROCESS AND PART OF LIFE. IT IS A HUGE LOSS OF HUMAN PERSONAL DIGNITY. NO ONE WANTS TO WEAR A DIAPER...IT IS DEHUMANIZING AND REPRESENTS A LOSS OF BODILY FUNCTION. NO PATIENT WANT THIS. HOWEVER AT A CERTAIN STAGE OF LIFE THERE IS NO OPTION, THIS IS A NECESSITY. GETTING A PARENT TO WEAR THE DIAPER IS A CHALLENGE IN ITSELF....

GEMS BACK OFFICE SHAME ON YOU.....SHAME ON YOUR LACK OF EMPATHY, MORALITY. HUMAN VALUES, SHAME ON YOUR TOTAL AND UTTER INCOMPETENCE..... THIS IS AN ENFRINGEMET AND VIOLATION OF MY MOTHERS HUMAN RIGHTS.

I WILL FORWARD A COMPLAINT TO MEDICAL AID OMBUDSMAN, AND COPY THIS TO ALL CUSTOMER SERVICE WEBSITES.

WHY DO WE AS GOVERNMENT WORKERS HAVE TO SETTLE FOR THIS ********** MEDICAL AID. ORHER OPTION JOIN ANOTHER MEDICAL AID BUT SUBSIDY WILL BE LOWER.

WHY OUR COLLECTIVE UNIONS DONT ACT ON GEMS IS ANOTHER ISSUE. Government employees are such a huge number of members, who can exert pressure on GEMS. THE POWER OF THE CONSUMER......GEMS RHINLS ALL OTS MEMBERS ARE FOOLS....THEY DONT RESPECT THE POWER OF NUMBERS OF THE CONSUMERS.

WHAT A BACKWARD ******** BUNCH OF STAFF. SHAME ON THEM

As it stands I have not been reimbursed on diapers purchased in April, May, June , July 2024.