GEMS
Miscommunication

My mother went to the dentist at Medicross Silverton for new dentures. Before the consultation, the receptionist called Gems to confirm benefits and advised her that there will be an additional payment of approximately R800. She agreed and they proceeded to make the dentures. When Medicross submitted the claim to Gems it was declined on the grounds that the benefits are exhausted. The total bill amounts to over R3000. When we followed up with Gems and Medicross, both entities failed to provide a clear explanation of what happened. My problem is the fact that work is done by Medicross for such a high amount without getting proper authorization. Irrespective of the fact that Medicross is contracted with GEMS, meaning that I do not even have to pay a levy or any extra amounts when I visit them. Now who is to be blamed for this gross irregularity?

Company: GEMS
Country: South Africa
City: Pretoria

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