GEMS
IT TAKES 1 MONTH OR LONGER FOR THEM TO RESPOND

I have submitted numerous auths for patients as I work at a busy cancer clinic. Usual turnarounds for medical aids are 48-72 hours. With GEMS I have dates pending from 28/01; 12/02; 01/02; 04/02; 05/02; 11/02; 05/02; 18/02; 08/02. These are actual dates of submission on actual patients that have generated query numbers. There is unacceptable call centre service and they are all trained to answer the phone "how can I help you with excellent customer service" - I am yet to see this. Then there is an escalations path who is forever complaining about the "duplicates generated by escalations" This wouldn't happen if they actually addressed the initial query. And who, as a cancer patient, is prepared to wait a month or longer to have their treatment authorized. They don't wait a month or more for your medical aid contribution, otherwise you are suspended. It is a dire condition, and I find it unacceptable that they have a life in the balance for this long! I even had a patient who had to turn to his lawyers for help as he ended up bleeding in hospital for a month before authorization was granted for a PMB condition, with a treatment of choice that is available to a state patient!

Company: GEMS
Country: South Africa
City: South Africa

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