1 reviews | Active since Jan 2016
Struggeling with gems to resolve claims
<p>1. My first complaint is with the courier pharmacy. I waited three weeks for my and my husband chronic medicine that we can't go without. They came back with a lot of excauses. That is unexptable to wait so long for one's chronic medicine.</p> <p>2. I struggled a month to claim money from gems, and to get it paid back to me. They did not even respond to my email that I send the second time.REF- ********** ********** 662 E - ********** 26298</p> <p>3. My next problem that needs to be resolved is with a outstanding account, that I have been struggeling now with for 5 weeks. It's regarding an ampath account of 06/12/2016 that was not paid because our recources have been depleted.My husband is registed for pmb and the blood work was done for his pmb condition. I can't understand why it was not paid?</p> <p>4. I am also struggeling now for 5 weeks to claim a nebulizer from gems. Each time the people at the authorisation department tells me they did not receive the papers. I know that some of the papers were not clear so I have send the new ons over a few times. Still they tell me they received nothing mh ********** 4.mh ********** 6</p> <p>My member number is ********** 91</p>
Good day
Thank you for alerting us to your concerns.
As indicated earlier we can confirm that upon completion of the authorsation on 7 March 2017, Medipost immediately processed the chronic medication script and that the medicines for both members were dispatched on 9 March 2017.
The account from Dr Potgieter to the value of R959.90 was refunded on 17 March 2017 and was deposited into your bank account on 20 March 2017.
We can further confirm that the account for services rendered on 6 December 2016 was referred for PMB adjudication but was declined as the ICD-10 codes reflected on the account did not qualify this as a PMB diagnosis.
The request for a nebuliser was approved to the maximum of R795 subject to the available 2017 medical appliance benefits. Please note that you will unfortunately be responsible for funding the balance for the nebuliser.
We apologise for any inconvenience caused.
Kind regards
The GEMS online team
Good day
Thank you for alerting us to your concerns.
As indicated earlier we can confirm that upon completion of the authorsation on 7 March 2017, Medipost immediately processed the chronic medication script and that the medicines for both members were dispatched on 9 March 2017.
The account from Dr Potgieter to the value of R959.90 was refunded on 17 March 2017 and was deposited into your bank account on 20 March 2017.
We can further confirm that the account for services rendered on 6 December 2016 was referred for PMB adjudication but was declined as the ICD-10 codes reflected on the account did not qualify this as a PMB diagnosis.
The request for a nebuliser was approved to the maximum of R795 subject to the available 2017 medical appliance benefits. Please note that you will unfortunately be responsible for funding the balance for the nebuliser.
We apologise for any inconvenience caused.
Kind regards
The GEMS online team