NK
Nately K

1 reviews | Active since Mar 2015

24 Mar 2015, 10:33

Hospital Authorisation

Yesterday the 23rd March 2015, I had to go and see a doctor,as I had a problem. He wanted to admit me immediately due to me having a tromboses Hemorrhoids. I asked if the hospital would get authorisation for me and he said yes due it being an emergency.<br> The hospital phoned for authorisation but was asked for letters from the Dr. We eventually sent it through but then because I am allergic to latex, they wanted a report to say I am allergic. After much waiting at the hospital and phoning back and forth to Affinity Health, they declined my admission with the following:<br> My latex allergy is a pre- existing condition? How do you have this as a 24 month waiting period when this is exactly like being allergic to *****illin?<br> They also say this is not an emergency and I did not give them 24 hour notice.<br> They also stated that although they had not yet requested and obtained the docs regarding the pre-existing element, it is assumed as the nature of the condition is not one that appears spontaneously but rather over a period of time.<br> I will be cancelling it with immediate affect and will not be paying for something when you can't even get authorisation for an emergency.<br>

0
Replies (1)
Affinity Health
Affinity Health's reply09 Apr 2015, 10:19
Official
Hello Natelyk,

Thank you for taking the time to report your experience.

Our claims administrator has been in contact with you and has sent through a letter in response to your request.

The reason your request was declined is because it does not fall within the benefit limits.Please expect a call from us to explain in detail the content of the letter.

Kind Regards,
The Affinity Health Management Team.