Inability to process Hospital claims for 70 days!!! GEMS

My problem is regarding non processing of in Hospital claims from you. The claims are visible on GEMS side and the claim is still not processed by your department. It’s a further problem that I cannot converse with a supervisor in this department, I was in Hospital on 31/12/17 and claim is still not processed. Please see ref numbers:: (some of which do not pertain to you but to GEMS)

31 /01 Ref Cape Town lungelo MH ********** 9 claim sent for processing

9/02 Daniel Jhb mh ********** 6

15/02 mh ********** 7 mpho customer service Cape Town

27/02 Mh ********** 1 Adrienne ref 270218qmvh20

01/03 thato Hospital claims gmsqr010318 Mpho ********** 245 **********

On this date Mpho gave me false info saying that THATO was a service leader. I have since found out that he is not. I contacted mpho again via email on Monday 05/03 with no reply from her.

I then got a call from Angus at the recovery team who said he would have resolution and call Me on Wednesday. He did so but has now re-escalated the matter. So it has been 70 days and the claim has still not been paid.

Secondly, I needed a repeat d and C on 13/02/18 auth number: ********** 4. ALL the documents were sent in together by myself and only half the claim has been processed. So it will be a repeat situation. Have you any idea how much emotional trauma I have been through from this miscarriage and now on top of it I am been harassed to pay bills that my medical aid should be sorting out and is not!