I have a spreadsheet with outstanding claims for appliances that i have submitted to the medical aid on behalf of a specialist and his patients/ the members. Our company administers doctors' accounts - some of these claims are as old as August last year. I have received reference number upon reference number and the claims are not being sorted out. I have spoke with various team leaders, but mostly to Bernice - i have requested contact details for the principal officer but were told its not available. Conveniently the Senior manager is always in a meeting and the Appliance dept do not have a direct contact number. The poor members are being handed over to our legal dept for outstanding claims, yet the medical aid still do not have feedback. This is not fair towards these members that pay a monthly premium to Gems medical aid and its also not fair towards the service provider who is not getting payment for these claims (some older than 4 months). Lastly its not fair that i in a professional capacity have to waste my time because processes at Gems medical aid (administered by Metropolitan Health) are NOT working. I will be advising the members/ Doctor to lodge a complaint with CMS
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