LD
Luticia D

1 reviews | Active since Sept 2016

25 Sept 2016, 21:45

POOREST of Poor Service

<p>Im writing this on behalf of a very distraughted member of GEMS.. The accident occurred 23 February 2016 which resulted in complete paralysis and member needing to be on a portable ventilator.</p> <p>The member was in surgical ICU for more than 100 days whilst waiting on authorisation to be moved to a Rehab. Eventually he was moved to rehab in May 2016, The eqtuipment ie. Wheelchair and vent he is using is loaned by the hospital whilst today 25.09.2016 he is still waiting on auth from medical aid. I have never ever come across a medical that keep asking for the same documents to be emailed, to date documents had been sent more than 5 times. Apparently the members situation is a special case "please advise what is so special about the matter". Also the ex gratia team is only busy with this case now since February 2016 .. Whilst this member is still lying in ICU which actually cost the medical aid 10 times more than just authorizing a wheelchair and a port vent. This is the most ridiculous story ever heard and I would want someone to call me ASAP as this matter will be going to the Council of medical aids. I don't even want to talk about the bills and the poor customer service ito call centre staff. </p> <p> </p> <p> </p>

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Replies (7)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply26 Sept 2016, 12:18
Official

Good day

Thank you allerting us to your authorisation complaint.

Please send us the name and membership number of the member so that we may look into the matter.

Kind regards

The GEMS online team

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply03 Oct 2016, 14:18
Official

Good day

Thank you for alerting us to your authorisation concerns.

As discussed, we have received the Ex gratia application form for the ventilator and have submitted it for review. Please can you let us know if the Ex gratia application form for the wheelchair was submitted.

Feedback will be provided on the outcomes of the Ex gratia committee once the case has been finalised.

Kind regards

The GEMS online team

LD
Luticia D's update03 Oct 2016, 18:24
Reviewer Update

Hi

As far as I know the documents has been sent. Info was sent as follows, the ventilator and assistant devices were requested via sleepnet and the ventilator was done via life ( rehab).

Could you give an indication as to how long this will take?

thanks

LD
Luticia D's update17 Feb 2017, 19:52
Reviewer Update

Good day, with reference to the above mentioned query I'm at the same disgusted stage again where I have to go this route to get your attention.

The above mentioned Gems patient has been discharged from hospital a month ago and we have been told that his wheelchair has been approved, however we are still waiting for any further action to be taken. This patient is a quadraplegic and is desperately in need of a wheelchair as he has started developing bedsores because of just being confined to his bed. Because of your lack of service you are taking away someone's dignity and quality of life by not acting efficiently I ask for your immediate attention to this matter or we will take this matter beyond this forum.

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply20 Feb 2017, 10:02
Official

Good day

Thank you for affording GEMS the opportunity to respond to your concerns.

We are looking into this and will revert soonest.

Kind regards

The GEMS online team

LD
Luticia D's update20 Feb 2017, 11:10
Reviewer Update

We need feedback by cob today . before we revert to the obuds/medical council.

LD
Luticia D's update21 Jul 2017, 13:45
Reviewer Update

does ANYBODY work at this company! THIS is PATHETIC SERVICE. What will it take for somebody to do what they ARE being PAID for. Somebody call with answers its months later and we havent heard a single thing.