tD
thobeka D

1 reviews | Active since Jun 2016

24 Dec 2018, 16:36

Unsettled hospital bills

I delivered my baby girl via C section on 9 February 2018 at St Augustine hospital in Durban. Up to this day my hospital bill has not been settled by Gems for reasons unknown to mankind. I was admitted on A Wednesday due to feotal distress and was monitored right through to Friday morning when my baby was completely exhausted and could not move at all and an emergency C section was perfomed. At first Gems stated there was an authorization dispute, then they stated that the hospital submitted claims which were incorrectly coded, i contacted the hospital and they agreed to resubmit of which they copied me in that correspondence, since then it has been email after email going back and forth and through it all the hospital has been very cooperative in terms of submitting what the scheme asks for. All this while the hospital handed me over to debt collectors who have been constantly in contact with me asking me to pay. The last few of my emails enquiring of the status quo were not responded to. I have been beyond patient and I have now been advised to take legal action. I can not pay the hospital because if i could, then I wouldn’t have joined a medical scheme in the first place.

0
Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply02 Jan 2019, 09:26
Official
Good day 
 
Thank you for giving us the opportunity to respond. We are looking into this and will respond as soon as possible. 
 
Kind regards 
The GEMS online team 
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply29 Jan 2019, 16:10
Official
Good day
 
Thank you for affording GEMS the opportunity to respond to your concerns regarding your unpaid account.
 
Please note that the account was rejected due to a billing error.  

The account has however been reprocessed and will be settled with the next claims run on 1 February 2019.

We apologise for any inconvenience caused. 
 
Yours in service, 
The GEMS Online Team