jJ
josephine J

1 reviews | Active since Apr 2017

26 Apr 2017, 11:32

service delivery

<p>I received an account for an in hospital event that took place on the 15/ 02/17, the 27/03/17. My first call to GEMS took place 20/03/17, ref no mh ********** 5, and was told that they would communicate within 3 days, it never happened.</p> <p>Consequent call 11/04/17, refno mh ********** 1, was told that account would be sent for PMB, and it would take 3days</p> <p>I called 19/ 04/ 17, refno mh ********** 0, and was told resolution would take place within 10days</p> <p>I called 21/04/17,mh ********** 6 still account not seen to.</p> <p>I called 26/04/17,ref no mh ********** 0 only to be told that it could take up to 30 days and the dye date for the account is 27/04/17.!!!!!</p> <p>As a member i am extremely disappointed and fed up with GEMS.</p> <p>Where is the quality service that I am paying for????</p> <p>Poor service delivery!!</p>

0
Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply26 Apr 2017, 12:49
Official

Good day

We apologise for your experience of GEMS so far. Please send us a private message with your membership number so that we can be of assistance.

Kind regards

The GEMS online team

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply17 May 2017, 12:54
Official

Good day

Thank you for bringing your concerns regarding your unpaid claim to our attention.

We can confirm that the account is accepted for payment for the next claims payment run dated 2 June 2017. The account was approved from the prescribed minimum benefit category and was processed at 300% of the Scheme rates. Please note that even though the account was processed at 300% of the Scheme rates, the invoice was substantially higher than the Scheme approved rates. Unfortunately, as per the rules of the Scheme the outstanding balance, not funded by GEMS, will be your responsibility.

We apologise for the delay in resolving this matter and for any inconvenience caused as a result.

Kind regards

The GEMS online team