GEMS
Waiting a month for authorisations on hearing aids

GEMS have always been a medical aid that you can rely on but since January 2013 we have been struggling a lot to get authorisation on hearing aids and even after authorisation has been obtained the claim are still rejected due to "authorisation not obtained". Most medical aid take 7 working days to give an auth but recently we have been waiting at least a month for auth. This puts my practise and professional name in a bad light, seeing that the patient thinks that it is us not doing our work. Several patients has phoned and said that they do not want the hearing aid anymore due to the fact that the process takes too long. This is costing my practise al lot of money and is Unacceptable! After an Auth letter is FINNALLY received they do not pay the claim because they did not pick up the Auth number on their system delaying the proses another month. At least 10 phone calls are made to the fund before Auth is obtained (an phone call will last at least 20 min, because they put you on hold or transfer you to another department) I have also been told several times that a team leader phone me back - I am still waiting for this to happen? What can be done about this situation??

Company: GEMS
Country: South Africa
City: South Africa

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