SB
Susan B
1 reviews | Active since Jun 2016
07 May 2019, 10:37
Not paying chronic medication refund!
Complaint - not paying Chronic Medication! I pay extra monthly premiums for my Chronic Medication, which has been approved by Affinity Health. However, when I submit my claim Affinity Health, refuses to pay the amount, or say that they have made a mistake and still do not refund me anyway!! I have been waiting 3 months for a refund. Excuses made and then not rectifying - how long is this going to carry on....?
Helpful (0)
Replies (7)0
Replies (7)
Affinity Health's replyOfficial
07 May 2019, 10:42Good say Susan
Thank you for bringing this matter to our attention.
Please be advised that the matter will be investigated, and a Complaints Officer will be in contact with you soon.
Kind regards
Affinity Health Management Team
Thank you for bringing this matter to our attention.
Please be advised that the matter will be investigated, and a Complaints Officer will be in contact with you soon.
Kind regards
Affinity Health Management Team
Affinity Health's reply07 May 2019, 10:42
Official
Good say Susan
Thank you for bringing this matter to our attention.
Please be advised that the matter will be investigated, and a Complaints Officer will be in contact with you soon.
Kind regards
Affinity Health Management Team
Thank you for bringing this matter to our attention.
Please be advised that the matter will be investigated, and a Complaints Officer will be in contact with you soon.
Kind regards
Affinity Health Management Team
SB
Susan B's updateReviewer Update
07 May 2019, 10:46Thanks for responding - I'll wait in anticipation of a result!
SB
Susan B's update07 May 2019, 10:46
Reviewer Update
Thanks for responding - I'll wait in anticipation of a result!
Affinity Health's replyOfficial
07 May 2019, 10:56You're most welcome.
Kind regards
Affinity Health Management Team
Kind regards
Affinity Health Management Team
Affinity Health's reply07 May 2019, 10:56
Official
You're most welcome.
Kind regards
Affinity Health Management Team
Kind regards
Affinity Health Management Team
SB
Susan B's updateReviewer Update
10 May 2019, 06:28The response a phone call with promises of further feedback.......but nothing since then!??
SB
Susan B's update10 May 2019, 06:28
Reviewer Update
The response a phone call with promises of further feedback.......but nothing since then!??
Affinity Health's replyOfficial
10 May 2019, 08:52Good morning Susan
Thank you for your patience.
It has been of concern investigating the details of how it came to be that upfront payments were erroneously being made for medications' cover, of which you had received authorisation.
As a result, the claim in dispute was processed as an Acute Medications claim, which does not include Chronic Medication.
So, you were reimbursed for the one medication, whilst the other medications were supposed to be collected as Chronic Medications without upfront payment.
The claims history of your medication remains under investigation, in order to assist you with removing barriers to claiming, whilst the reimbur*****t claim is being escalated for reprocessing.
A claims procedure guide is being drafted and emailed to you in order to assist you going forward.
Kind regards
Affinity Health Management Team
Thank you for your patience.
It has been of concern investigating the details of how it came to be that upfront payments were erroneously being made for medications' cover, of which you had received authorisation.
As a result, the claim in dispute was processed as an Acute Medications claim, which does not include Chronic Medication.
So, you were reimbursed for the one medication, whilst the other medications were supposed to be collected as Chronic Medications without upfront payment.
The claims history of your medication remains under investigation, in order to assist you with removing barriers to claiming, whilst the reimbur*****t claim is being escalated for reprocessing.
A claims procedure guide is being drafted and emailed to you in order to assist you going forward.
Kind regards
Affinity Health Management Team
Affinity Health's reply10 May 2019, 08:52
Official
Good morning Susan
Thank you for your patience.
It has been of concern investigating the details of how it came to be that upfront payments were erroneously being made for medications' cover, of which you had received authorisation.
As a result, the claim in dispute was processed as an Acute Medications claim, which does not include Chronic Medication.
So, you were reimbursed for the one medication, whilst the other medications were supposed to be collected as Chronic Medications without upfront payment.
The claims history of your medication remains under investigation, in order to assist you with removing barriers to claiming, whilst the reimbur*****t claim is being escalated for reprocessing.
A claims procedure guide is being drafted and emailed to you in order to assist you going forward.
Kind regards
Affinity Health Management Team
Thank you for your patience.
It has been of concern investigating the details of how it came to be that upfront payments were erroneously being made for medications' cover, of which you had received authorisation.
As a result, the claim in dispute was processed as an Acute Medications claim, which does not include Chronic Medication.
So, you were reimbursed for the one medication, whilst the other medications were supposed to be collected as Chronic Medications without upfront payment.
The claims history of your medication remains under investigation, in order to assist you with removing barriers to claiming, whilst the reimbur*****t claim is being escalated for reprocessing.
A claims procedure guide is being drafted and emailed to you in order to assist you going forward.
Kind regards
Affinity Health Management Team
SB
Susan B's updateReviewer Update
10 May 2019, 09:03Thanks for your response. I was expecting a call some days ago. It's nice that you are drafting a procedure guide after my being a member for 1.5 years. Now I know the claims procedure has changed I can order accordingly! I hope this helps others.
Note: your team obviously does not read emails carefully since I marked my claims as CHRONIC MEDICATION and included my chronic letter on both occasions.
SB
Susan B's update10 May 2019, 09:03
Reviewer Update
Thanks for your response. I was expecting a call some days ago. It's nice that you are drafting a procedure guide after my being a member for 1.5 years. Now I know the claims procedure has changed I can order accordingly! I hope this helps others.
Note: your team obviously does not read emails carefully since I marked my claims as CHRONIC MEDICATION and included my chronic letter on both occasions.
Affinity Health's replyOfficial
10 May 2019, 09:22Thank you for your advice Susan.
Kindly remember that due to your chronic medication being authorised already, it was not supposed to be repeatedly submitted as a reimbur*****t claim, you were merely supposed to collect your medication at the pharmacy.
Please await your email with the correct claims process soon.
Kind regards
Affinity Health Management Team
Kindly remember that due to your chronic medication being authorised already, it was not supposed to be repeatedly submitted as a reimbur*****t claim, you were merely supposed to collect your medication at the pharmacy.
Please await your email with the correct claims process soon.
Kind regards
Affinity Health Management Team
Affinity Health's reply10 May 2019, 09:22
Official
Thank you for your advice Susan.
Kindly remember that due to your chronic medication being authorised already, it was not supposed to be repeatedly submitted as a reimbur*****t claim, you were merely supposed to collect your medication at the pharmacy.
Please await your email with the correct claims process soon.
Kind regards
Affinity Health Management Team
Kindly remember that due to your chronic medication being authorised already, it was not supposed to be repeatedly submitted as a reimbur*****t claim, you were merely supposed to collect your medication at the pharmacy.
Please await your email with the correct claims process soon.
Kind regards
Affinity Health Management Team