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Terrible Pre-Approval Process - Aetna Review

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Terrible Pre-Approval Process

They actually denied a treatment claiming that it was not medically necessary and instead recommended something that was damaging. Apparently, the pre-approval process goes something like this...Board-certified surgeon recommends a course of treatment, recommendation is reviewed by NURSES, who in this case picked a cheaper course that would actually do damage. Reviewed recommendation is then forwarded to a Medical Director who is either not reading them or is under-informed. So now the burden of proof is left on the original physician.

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1.0 Cost
1.0 Service
1.0 Claims

Aetna Ratings

  • 1.7 coverage
  • 2.3 cost
  • 1.3 service
  • 1.2 claims
  • 1.6 overall rating

Based on 210 reviews - 1 is lowest, 5 is highest

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