WS
Walter S
1 reviews | Active since Apr 2009
10 Jul 2022, 20:27
Affinity not paying
For a second time now they're not paying for my medical treatment. Doctor sent me for blood tests which they did not pay. Now I have lawyers phoning me. Went to the dentist to replace a filling. Got a bill from the dentist saying Affinity did not pay.
Helpful (0)
Replies (5)0
Replies (5)
Affinity Health's replyOfficial
11 Jul 2022, 08:22Good Day Senekal,
Thank you for raising your concerns with us.
Please be advised that your complaint will be investigated and an outcome will be communicated to you in due course.
Kind Regards,
Affinity Health Management Team
Thank you for raising your concerns with us.
Please be advised that your complaint will be investigated and an outcome will be communicated to you in due course.
Kind Regards,
Affinity Health Management Team
Affinity Health's reply11 Jul 2022, 08:22
Official
Good Day Senekal,
Thank you for raising your concerns with us.
Please be advised that your complaint will be investigated and an outcome will be communicated to you in due course.
Kind Regards,
Affinity Health Management Team
Thank you for raising your concerns with us.
Please be advised that your complaint will be investigated and an outcome will be communicated to you in due course.
Kind Regards,
Affinity Health Management Team
Affinity Health's replyOfficial
14 Jul 2022, 11:03Good Day Senekal,
We thank you for taking the time to speak with us regarding your dentistry benefits.
We can confirm that the claim in question was processed and paid according to protocol.
Should you require any further clarity with regards to the dentistry benefits on your plan, please do not hesitate to get in touch with us.
Thank you.
Kind Regards,
Affinity Health Management Team
We thank you for taking the time to speak with us regarding your dentistry benefits.
We can confirm that the claim in question was processed and paid according to protocol.
Should you require any further clarity with regards to the dentistry benefits on your plan, please do not hesitate to get in touch with us.
Thank you.
Kind Regards,
Affinity Health Management Team
Affinity Health's reply14 Jul 2022, 11:03
Official
Good Day Senekal,
We thank you for taking the time to speak with us regarding your dentistry benefits.
We can confirm that the claim in question was processed and paid according to protocol.
Should you require any further clarity with regards to the dentistry benefits on your plan, please do not hesitate to get in touch with us.
Thank you.
Kind Regards,
Affinity Health Management Team
We thank you for taking the time to speak with us regarding your dentistry benefits.
We can confirm that the claim in question was processed and paid according to protocol.
Should you require any further clarity with regards to the dentistry benefits on your plan, please do not hesitate to get in touch with us.
Thank you.
Kind Regards,
Affinity Health Management Team
WS
Walter S's updateReviewer Update
14 Jul 2022, 12:57The protocol is insane. So regarding your dental cover you don't identify my front teeth as part of my mouth. Sorry but that is just mental. This must have been setup by someone from Capetown that don't value their front teeth.
WS
Walter S's update14 Jul 2022, 12:57
Reviewer Update
The protocol is insane. So regarding your dental cover you don't identify my front teeth as part of my mouth. Sorry but that is just mental. This must have been setup by someone from Capetown that don't value their front teeth.
Affinity Health's replyOfficial
14 Jul 2022, 14:00Good day Senekal,
Thank you for your response.
As advised, your dental claim was paid according to your policy terms and conditions.
Kind Regards,
Affinity Health Management Team
Thank you for your response.
As advised, your dental claim was paid according to your policy terms and conditions.
Kind Regards,
Affinity Health Management Team
Affinity Health's reply14 Jul 2022, 14:00
Official
Good day Senekal,
Thank you for your response.
As advised, your dental claim was paid according to your policy terms and conditions.
Kind Regards,
Affinity Health Management Team
Thank you for your response.
As advised, your dental claim was paid according to your policy terms and conditions.
Kind Regards,
Affinity Health Management Team
WS
Walter S's updateReviewer Update
31 Aug 2022, 16:41I joined Affinity in 1st of December 2014.
DENTISTRY COVER BENEFITS: Basic dentistry is covered, 2 intra oral radiographs, 1 scale and polish, extractions (Only 1 per quadrant per member per year) emergency treatment including amalgam fillings. Treatment as per Affinity Health Formulary. This was the benefits when I joined you.
Nowhere here does it make mention of back and front teeth. You're in breach of our original agreement. You cant change my benefits without contacting me and explaining to me exactly what is going to impact me and if I still want to be a client.
DENTISTRY COVER BENEFITS: Basic dentistry is covered, 2 intra oral radiographs, 1 scale and polish, extractions (Only 1 per quadrant per member per year) emergency treatment including amalgam fillings. Treatment as per Affinity Health Formulary. This was the benefits when I joined you.
Nowhere here does it make mention of back and front teeth. You're in breach of our original agreement. You cant change my benefits without contacting me and explaining to me exactly what is going to impact me and if I still want to be a client.
WS
Walter S's update31 Aug 2022, 16:41
Reviewer Update
I joined Affinity in 1st of December 2014.
DENTISTRY COVER BENEFITS: Basic dentistry is covered, 2 intra oral radiographs, 1 scale and polish, extractions (Only 1 per quadrant per member per year) emergency treatment including amalgam fillings. Treatment as per Affinity Health Formulary. This was the benefits when I joined you.
Nowhere here does it make mention of back and front teeth. You're in breach of our original agreement. You cant change my benefits without contacting me and explaining to me exactly what is going to impact me and if I still want to be a client.
DENTISTRY COVER BENEFITS: Basic dentistry is covered, 2 intra oral radiographs, 1 scale and polish, extractions (Only 1 per quadrant per member per year) emergency treatment including amalgam fillings. Treatment as per Affinity Health Formulary. This was the benefits when I joined you.
Nowhere here does it make mention of back and front teeth. You're in breach of our original agreement. You cant change my benefits without contacting me and explaining to me exactly what is going to impact me and if I still want to be a client.