Had went to the Waterfall Netcare Hospital causality section after an accident. Since then it has been a nightmare to have to claim attended to by GEMS. No one wants to take ownership of what the problem could be. I keep being told that it is processed by the claims department, told to call back or given some silly reason that it is declined. In the midst of trying to get an answer from GEMS on payment, I have been hounded by the hospital for payment with me having received a final letter of demand on the 4 June 2013. On the 12 April 2013: GEMS informed me that the claim was rejected. When I called the GEMS call centre I was told to contact the hospital to request them to resubmit the claim as "an emergency claim on EDI which I had done. On the 17 April 2013: GEMS indicated to me that again the claim was declined. The reason was that my medical saving account was depleted. That seemed was odd because I am on the option that does not have a medical savings account. On the 8 May 2013: I was then told by GEMS that I should get the invoice from the hosipital and email it to the claims section. On the 25 May 2013: I was told by GEMS that the claim was declined as there were wrongcodes.
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