GK
Gabi K

1 reviews | Active since Oct 2013

06 Dec 2015, 22:25

Unpaid account despite pre-authorisation

I am a service provider. I app**** for pmb for an at risk client. The pmb was approved however every time an account is submitted the claims department indicates that the funds are exhausted. We have contacted the department and explained multiple times that this is a pmb claim. The pmb department confirms that this has been approved. Yet the claims gets rejected regardless. We are then told to resubmit and wait for 7 - 10 working days where the whole process is repeated. I originally submitted the claims months ago and have gone through this process numerous times with ABSOLUTELY no progress. <br> <br> I deal with all the major medical aids on a daily basis and have never experienced such incompetence.

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Replies (1)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply07 Dec 2015, 13:16
Official
Hello Psych101,

Thank you for the opportunity given to GEMS to respond to your concerns.
A consultant will be in contact soon to provide you with the necessary assistance.

Please allow us a little time to investigate your complaint.


Kind Regards
The GEMS Online Team