ZW
Zirkia W

1 reviews | Active since Mar 2020

18 Nov 2022, 16:24

Who's at fault?

So following protocol paying upfront, having a auth number: See sms:AFH Authorisation (***) granted for service 01Nov Amount Authed:R1500 Shortfall:R Co-pay:R T&C apply

Knowing I can afford to see specialist because I will get reinbursed, I visit the Dr. Aftera submiting claim This is the reply:Good day,

I trust you are well.

Kindly note that the claim was paid up to maximum benefit available.

The authed amount was issued by a system error, therefore we are only able to reimburse up to the amount of R200.00 for the consultation.

Should you require any further assistance, please feel free to contact us on ***or reply to me directly.

Regards,

So who should cough up the money? Who's error was this then?

Ps this page says medical aid its an Insurance and yes great reviews for queries however when it comes to what they pay who they pay, medication and procedures they are horrible! Always a story and always some red tape! Im so done!

Dont even try phoning me first sort out your mess! Can contact me when you fix your error

0
Replies (4)
Affinity Health
Affinity Health's reply18 Nov 2022, 16:33
Official
Good Day  Zirkia, 
 
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
ZW
Zirkia W's update18 Nov 2022, 16:59
Reviewer Update
Not intrested, reinburse as per authorisation supp****! Until the money is not paid and reflecting on my bank account I do not want to hear anything thing I will take this matter futher since this is not the 1st time our paths are crossing regarding reinbur*****ts! Done talking and hearing excuses. Lukily I have all the evidence to make my point known..
Affinity Health
Affinity Health's reply21 Nov 2022, 16:25
Official
Good day  Zirkia,

Please note that your Complaint has been escalated accordingly a Complaints Officer will be in touch with you shortly.
We apologize for any inconvenience caused. 
 
Kind Regards 
Affinity Health Management Team
Affinity Health
Affinity Health's reply05 Dec 2022, 15:05
Official
Good Day  Zirkia, 
 
We can confirm that your claim has been processed and paid according to protocol.
 
We thank you for your continued support.
 
Kind Regards 
Affinity Health Management Team