MH
Michelle H

1 reviews | Active since Jan 2012

03 Nov 2015, 19:17

Non payment of doctors bills

I used my policy for the first time, I had mole removed at my GP. I called Affinity and it was pointed out that they would only pay a portion of the drs fee as it was a doc of my choice. I was ok with that. The mole was removed on the 5 th August and sent to pathology. I sent the accounts in on the 8th. I heard nothing , on around the 15 th I was told they had not been received, wrong e mail address...... supp**** by the call center.I resent them . I received sms notification that they would be paid and the amounts.....It is now November neither me nor the pathologist have been reimbursed . Upon no payment I contacted them to find that the claim had been rejected, I needed a referral letter from the doctor, which I promptly supp**** .They then hassled about codes, I said tell me exactly what you want and I will sort it out, no reply. With each communication the doc bill which is not in dispute, is going to paid.... and guess what , no payment arrives. I feel their comprehensive plan is misleading and obscure and these people have no intention of paying me out . Pls be very wary of Affinity Health Insurance. I don't think its worth the paper it is written on

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Replies (1)
Affinity Health
Affinity Health's reply04 Nov 2015, 09:23
Official
Hello mhoward,

Thank you for communicating with us on Hello Peter. Our Escalations Manager is in the process of investigation this matter and will be in contact with you shortly to discuss a resolution to your query.

Please take note however, that we offer basic pathology linked to the Affinity Health Pathology formulary and unfortunately the tests that were completed were not according to our protocol.

Our Customer Care Agents are always available to clarify any uncer*****ies with regard to benefits available on our policies.

Kind regards,
Affinity Health Management Team