DS
Dawn S

1 reviews | Active since Oct 2025

14 Oct 2025, 13:52

Refund claim for NIPT rejected multiple times

For the past 2 months I have been struggling to get a refund for the NIPT test I received pre -authorization for. It has been rejected 4 times. Every single time with a different excuse. I sent them the pathology invoice, my payment receipts, my results, my dr. motivation, my lab request form. Every possible thing I have as proof that I did the test was sent. Yet it keeps on getting rejected. I sent an email to their complaints department with no reply about two weeks ago.

They are causing me so much stress. I am already a high risk pregnancy with extra approval on the maternity program and they just keep on adding more stress. Why did I need to get authorization if they find any excuse not to pay out. This is unacceptible. I expect to be refunded for something I was pre-authorized for. They are trying to find any excuse not to refund me.

I also do not receive any communication from them, I only find out when I follow up. There is also nobody that can tell me what exactly they are looking for or missing it is just the code is wrong and when asked what the code must be they can't tell me. I am fed up and considering taking legal action. Surely I can't be the 1st person in history to claim for this test.... really. I wish I could give them zero stars. I have been a member for 8 years claiming very little over this time and this is what I get when trying to get refunded for a test I got special authorization for.

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Replies (1)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply14 Oct 2025, 14:37
Official
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