TM
Taryn M
1 reviews | Active since Mar 2017
13 Dec 2018, 20:24
Once again incompetence at GEMS
After going through hell with GEMS to get authorisation for an operation, my mother's condition was declared a PMB. After the operation, I received Bill's for shortfalls and was told I could send these through for PMB consideration. Several phone calls later and a complaint to the complaints department and still no feedback. Each time I phone someone tells me they will submit these codes. Then what did the previous person do? I have never encountered such an *********** company. Do you think we have the time, money and resources to keep going back and forth with you. SOMEBODY DO YOUR JOB, JUST LIKE I DO TO PAY YOU! Reference numbers: MH ********** 2 ********** MH ********** 059 MH ********** 3
Helpful (0)
Replies (3)0
Replies (3)Gems (Government Employees Medical Scheme)'s replyOfficial
14 Dec 2018, 09:44Good day
Thank you for giving us the opportunity to respond. We are looking into this and will respond as soon as possible.
Kind regards
The GEMS online team
Thank you for giving us the opportunity to respond. We are looking into this and will respond as soon as possible.
Kind regards
The GEMS online team
Gems (Government Employees Medical Scheme)'s reply14 Dec 2018, 09:44
Official
Good day
Thank you for giving us the opportunity to respond. We are looking into this and will respond as soon as possible.
Kind regards
The GEMS online team
Thank you for giving us the opportunity to respond. We are looking into this and will respond as soon as possible.
Kind regards
The GEMS online team
Gems (Government Employees Medical Scheme)'s replyOfficial
10 Jan 2019, 10:43Good day
Thank you for alerting us to your concerns regarding unpaid accounts.
Kindly be advised that your claim was referred to the authorisations department for PMB adjudication and the claims were reworked accordingly. The provider was contacted and they confirmed that once the claims are reprocessed as a PMB, the balance amounting to R2,246.45 will be written off.
An additional amount of R2,319.35 was processed on the hospital account and the member will remain liable for an amount of R104.88 (tariff code 58272).
Please accept our sincere apologies for the delay in resolving this matter.
Kind regards
The GEMS online team
Gems (Government Employees Medical Scheme)'s reply10 Jan 2019, 10:43
Official
Good day
Thank you for alerting us to your concerns regarding unpaid accounts.
Kindly be advised that your claim was referred to the authorisations department for PMB adjudication and the claims were reworked accordingly. The provider was contacted and they confirmed that once the claims are reprocessed as a PMB, the balance amounting to R2,246.45 will be written off.
An additional amount of R2,319.35 was processed on the hospital account and the member will remain liable for an amount of R104.88 (tariff code 58272).
Please accept our sincere apologies for the delay in resolving this matter.
Kind regards
The GEMS online team
TM
Taryn M's updateReviewer Update
05 Mar 2019, 14:58I have been waiting for feedback for 2 weeks now. The doctors rooms have now sent me a letter of demand, threatening to blacklist me after Gems assured me that this account was taken care of. Please contact me urgently on ********** 786.
TM
Taryn M's update05 Mar 2019, 14:58
Reviewer Update
I have been waiting for feedback for 2 weeks now. The doctors rooms have now sent me a letter of demand, threatening to blacklist me after Gems assured me that this account was taken care of. Please contact me urgently on ********** 786.
