TE
Thembalethu E

1 reviews | Active since Jan 2018

11 Jan 2019, 15:38

Unpaid Specialist Doctor by GEMS 14 March 2018

Good day. I am Thembalethu Mpahlaza a member of GEMS with membership no ********** 88. On 10 March 2017 my wife who is the dependant on my medical aid gave birth at Beacon Bay Life Hospital in East London with the authorisation number . Shortly after that we were provided by Home Affairs birth registration forms for the new born. I completed the said documents on spot ,however we were advised to visit Home Affairs for birth registration of the newborn and afterward to contact GEMS to provide us with the GEMS Newborn Registration Forms. Bear in mind that the 10th March 2018 was on Saturday and my wife was hospitalised and got discharged on Monday the 12th of March 2018.

On 14 March 2018 I went to Home affairs offices with the aim of obtaining Birth Certificate of the child and I immediately contacted GEMS to request the Newborn Registration Forms and their call center Agent Vhonani Thanyani emailed me (Mar 14, 2018, 8:29 AM) the forms and advised me to email it back soon after completing it which I did same day. (from: Thembalethu ********** to: Vhonani Thanyani ********** date: Mar 14, 2018, 3:00 PM)

On 30 June 2018 I received communication from the Specialist who was responsible for the birth of the child Dr. Makhomba informing me that GEMS effected no payment to his services since the new born baby was not registered. I insisted to him that I did all to register the baby.

On 02 July 2018 I re-contacted GEMS to sort reasons for the delay in the registration of my child and I spoke to an Agent in the name of Zinhle Mahlangu whom I also provided with the initial communication and attachments sent to GEMS on the 14th March 2018. I hoped that the matter shall be resolved as she also advised me to share similar email communication with someone I thought was senior to her in the name of AN Malungani.

from: Thembalethu ********** to: Gems ********** date: Jul 2, 2018, 8:39 AM subject: Fwd: ********** 88 MR T MPAHLAZA mailed-by: gmail.com

from: Thembalethu ********** to: ********** date: Jul 2, 2018, 2:11 PM subject: Fwd: ********** 88 MR T MPAHLAZA mailed-by: gmail.com

It came with shock to learn that GEMS never registered my new born baby and I learn about that when I took the child to the Doctor who advised me to again register the baby as a child not new born etc which I did.

What i want to make it clear is that GEMS failed to perform its function and for that they must pay the said Doctor not myself. The Doctor is now considering legal action against me which will border into legal costs which I don't have. Can someone attend to this asap.

My contacts are as follows: ********** or ********** email: ********** fax ********** .

Regards

0
Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply11 Jan 2019, 16:07
Official
Good day

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

Kind regards
The GEMS online team
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply21 Jan 2019, 12:17
Official
Good day

Thank you for bringing your concerns regarding the registration of dependants to our attention. 

Please be advised that based on our investigation, it is confirmed that the new born was not registered within 60 days of the birth date and therefore was registered as of 1 August 2018 with a 3 month waiting period. The effective benefit date is therefore 1 November 2018. 

We trust the above is in order. 

Kind regards
The GEMS online team