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Michelle M

1 reviews | Active since Nov 2018

22 Nov 2018, 16:48

Shocking service

I have been trying to submit a claim and have it processed. I was told to send in an invoice with a service date, I did this on 23 October. Every time I call in I am told that this will be escalated. Still no answers.

I have also been trying to add my husband who is currently on a medical aid as a dependent. A month later and numerous called with promised call backs to update me I again phoned today and was told he has been added but now has a 3 month waiting period. which means that if he is in an accident etc he will not be treated. Therefor he will no longer be joining GEMS but rather staying on his present medical aid.

The call center staff do not know what they are doing and constantly say they are escalation the issue but nothing comes of it!!! The website never works and as for the app it is a joke!!!

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Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply23 Nov 2018, 09:35
Official
Good day

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

Kind regards
Natasha

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply03 Dec 2018, 12:40
Official
Good day

Thank you for alerting us to your claim and membership concerns. 

We can confirm that the claim in question was received and processed in time. However, the claim was rejected as no referral practice number was provided. The rejection was noted on your claims statement.

Upon receiving all the documentation required, the dependent’s membership was registered effective 1 January 2019 with a three month general waiting period.  

We apologise for any inconvenience caused.  

Kind regards
The GEMS online team