Clamping down on irregular claims

One of these process changes is the termination of direct payments to certain healthcare service providers due to fraud sanctions placed against them by the Scheme. As of June 2013, these healthcare service providers' claims will be rejected and you, as the GEMS member, will be responsible for submitting the claim for the services rendered directly to the Scheme. This means you will have to pay healthcare costs for services from this healthcare provider directly to them.

Your claim submission must include corresponding details and valid proof of payment, signed by the principal member, in the form of:

• A valid stamped receipt from the provider;
• An electronic funds transfer (EFT) slip; or
• A bank deposit slip.

Your support regarding this change in process is appreciated, as GEMS continues to protect your benefits. We sincerely thank you for joining us in our dedicated fight against fraud.