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JH
Johan H

1 reviews | Active since Jun 2022

08 Dec 2023, 17:10

Affinity health

My doctor booked me for a medical procedure at the Life Ancron hospital. The hospital started to get pre-authorization on Tuesday the 5th of December 2023. Thursday in morning I received a call and a consent form from Affinity that I had to complete. I managed to get it done before lunch the same day. Today, Friday the 8th of December the hospital call me and tell me that they struggle to get the authorisation from Affinity. I called them and the person that helped me told me that the authorisation was sent to a panel for reviewing. After 2pm the hospital called again, but still no answer. I called them and got the same answer. It is now after 5 pm and still no authorisation. I am booked at the hospital for Monday the 11th and I think I will have to cancel the whole thing. I am very disappointed in this treatment. I am a member since 1st of January 2023 and this is my first claim.

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Replies (5)
Affinity Health
Affinity Health's reply08 Dec 2023, 17:57
Official
Good Day Johan,

We appreciate you taking the time to share these concerns with us.

Kindly note that your concerns will be relayed to the Complaints Department for further investigation and assistance.

Kind regards
Affinity Health Management Team
JH
Johan H's update08 Dec 2023, 18:51
Reviewer Update
I received a call later this afternoon telling me that my authorisation was declined due the fact there is a waiting period of two or three years on the procedure that I was booked for. I told them I will review my position with them
Affinity Health
Affinity Health's reply08 Dec 2023, 19:57
Official
Good Evening Johan,

We can confirm that the Pre-Authorisation Department was in contact with you to provide you with feedback regarding your authorisation request.

We can further confirm that email communication was sent through, advising of the 12 months waiting period that would be applicable.

Should you require any further clarity or assistance, kindly let us know and we will gladly assist.

Best regards,
Affinity Health Management Team
JH
Johan H's update09 Dec 2023, 04:51
Reviewer Update
By the end of the year I will be a year with Affinity. They told me that I must wait another year to claim for this type of procedure. I did not receive any email from them recently. I will check my emails for any other emails from them
Affinity Health
Affinity Health's reply11 Dec 2023, 14:33
Official
Good Day Johan,

We can confirm that a Complaints Officer has been in contact with you to discuss the above concerns and to provide you with further clarity.

Should you require any further assistance, please do not hesitate to let us know.

Kind regards,
Affinity Health Management Team