ET
Ettiene T

1 reviews | Active since Mar 2009

06 Sept 2018, 11:36

Playing ping pong with peoples lives and not paying claims

I have been struggling from the 14th of August to get a claim paid. It keeps getting rejected because according to day to day I need authorisation and according to the people from authorisations gems do not give authorisation for the claim and it must be paid from day to day. I have phoned about 20 times and just get shoved from day to day to authorisations and back, feels like they are playing ping pong with me and the claim is not getting settled. In the meanwhile Dr. Pio from Wilgeheuwel refuses to give me my test results until the claim is paid.

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Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply06 Sept 2018, 15:22
Official

Good day

Thank you for the opportunity to respond to your concerns. We are looking into this and will provide feedback.

Kind regards

The GEMS online team

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply07 Sept 2018, 16:16
Official

Good day

Thank you for altering us to your account concerns.

Please be advised that the account was rejected for payment as we require clinical motivation from your doctor in order for us to consider payment.

We trust the above is in order.

Yours in service

The GEMS online team