ZG
Zinhle G

1 reviews | Active since May 2020

08 Oct 2021, 23:47

Treasure,poor customer service etiquettes

It is with GREAT disappointment that I'm writing to you. Firstly your staff member Treasure not adequately trained for customer service,he is not customer centric at all if being in the claims teams means you have to be so rude affinity will sure to loss lots of money because of him. Tonight I got admitted into casualty for sever stomach cramps and diarrhea after basic test were done Dr confirmed that he needed to more test for possible appendicitis.on the line hospital and myself spoke to Tresuare who told my I must go to State hospital or provide him with bill history of over a year back at 10pm Friday evening. This is despite the fact that I am paying customer he was not courteous at all and was not willing to listen to me as customer. When I wanted to speak to manager he refused me my right to speak to superior as though as making an unreasonable demand.he lacked empathy,the 1ingredient required when taking that role If I'm not going to get service then what am I paying for,my health is compromised, should anything happen to me going forward affinity is to blame.

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Replies (2)
Affinity Health
Affinity Health's reply09 Oct 2021, 11:40
Official
Good Day  Zinhle
Thank you for voicing your concerns with us.

It is not our intention to cause our members any distress in their time of need.

This matter will be thoroughly investigated and feedback will be communicated in due course.

Best Regards
Affinity Health Management Team 
Affinity Health
Affinity Health's reply13 Oct 2021, 15:59
Official
Good day Zinhle,

We have taken the time to review your complaint and would like to clarify our process for authorization for ease of use.

Upon request for admission, Affinity Health requested your medical history for clinical assessment. These documents are requested to assess and determine the benefit from which authorization will be covered.  This is also used to determine whether the condition may be pre-existing or not.

This process is put in place to ensure that once the guarantee of payment is issued, members are aware of how much Affinity Health will cover towards the admission and to avoid unexpected shortfalls for members.

Should medical history not be available at the time of authorization request, we recommended that our patients consult with an alternative treating facility, which may include a state facility, to ensure that they do not delay treatment which could be detrimental to their health.

Our members' well-being is very important to us and it will be beneficial for us to obtain the requested medical history to avoid any further delay in treatment.

Kind regards,
Affinity Health Management Team