AM
Adele M
1 reviews | Active since Oct 2023
19 Jan 2025, 09:15
PMB condition not funded as per PMB Care plan and PMB requirements.
My INR blood test (prothrombin index) code 3805 Mauff and Partners 28/11/2024 has not been paid in full. Short paid by R110.30.
You have compelled me to use Warfarin and not Xarelto as prescribed by my doctor. On Warfarin I need to have this test done at least monthly when well controled and weekly to two weekly when not well controled.
I find it strange that this claim is not paid as per on the claims statement the wrong tarrif was charged, when it has been paid on this code and amount previously. These tests are approved on my PMB care plan yet not paid!! Kindly please sort this out and fund in full as per my PMB care plan.
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Replies (1)Gems (Government Employees Medical Scheme)'s replyOfficial
20 Jan 2025, 08:53Good day,
Thank you for engaging with us.
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Regards,
GEMS
Gems (Government Employees Medical Scheme)'s reply20 Jan 2025, 08:53
Official
Good day,
Thank you for engaging with us.
We are attending to your message and feedback will be provided. 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
