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nel.madelyn nel.madelyn

1 reviews | Active since May 2017

03 May 2017, 21:00

What more to do....

<p>In 2016 I had a successfull PMB application.On 5/12/2016 I visited a medical practioner still under this PMB.Up to date this account has not been paid by GEMS even though there is no reason for this by GEMS.In the last week I spend 75 minutes on the phone trying to come to a conclusion.Today I was told that the account is to old and I had to query the account earlier(before 4 months).This however was done on numerous occassions by myself and the dr.Due to the fact that this account was ones again rejected today,I am not able to visit the dr again,this is not good news for my health.Today I phone and spoke to an Elizabeth and she couldnt give me answers and the phone was put in my ear.Each month they take my R3800 but when I need them or just answers I get nothing.Feeling really frustrated......</p>

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Replies (6)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply04 May 2017, 09:59
Official

Good day

Thank you for affording GEMS the opportunity to respond to your concerns. Please send us a private message with your membership number.

Kind regards

The GEMS online team

nn
nel.madelyn nel.madelyn's update08 May 2017, 20:36
Reviewer Update

And still no answer.You are wasting with peoples lives....

nn
nel.madelyn nel.madelyn's update08 May 2017, 20:36
Reviewer Update

And still no answer.You are wasting with peoples lives....

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply23 Jun 2017, 14:33
Official

Good day

Thank you for raising your concerns regarding PMB's.

We can confirm that that the account for services rendered 05 December 2016 was approved as a PMB.

Please note that the account was referred to the Scheme for approval, as the account is older than four months. Conclusive feedback will be provided once the account has been finalised.

We apologise for the delayed response and any inconvenience caused in this regard.

Kind regards

The GEMS online team

nn
nel.madelyn nel.madelyn's update10 Jul 2017, 11:55
Reviewer Update

I am absolutely furious right now.I just got an e-mail from my dr saying GEMS short paid again!I cant go on like this anymore.Still no feedback or answers.You are playing with peoples lives....What the hell GEMS

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply18 Jul 2017, 11:08
Official

Good day

Thank you for bringing your concerns regarding your unpaid claim to our attention.

As per our communication with you, we can confirm that the account was approved from the prescribed minimum benefit category and was paid on 14 July 2017.

We apologise for the delay in resolving this matter and for any inconvenience caused as a result.

Kind regards

The GEMS online team