It really is a curse being a member of the GEMS Medical Aid as you have to deal with ill equipped people.
On the 7 November 2013 my wife visited their network doctor and was referred to a gynaecologist. In keeping with the GEMS rules on that very same day I called GEMS to inform them about this and get the required authorisation.
I was asked to send through the referral letter and was given the reference number 071113/QDRYML. Finally after a long deal I was contacted by GEMS told that authorisation had been granted.
On the 5 December 2013 I received a GEMS statement indicating that the gynaecologist bill was not paid because a specialist referral and pre-authorisation was required.
It is frustrating as it defeats the purpose of going through the whole pre authorisation process. Despite having adhered to all the procedures I am back at square one because clearly people who work at GEMS do not know how to do their jobs.
It could be forgiven if it was the first time, but every time you have to use the medical aid you have to go through this rigmarole. When will GEMS get it right. When will the GEMS Management listen to the plight of members.
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