Complicated and Disorganized
My daughter received medical treatment that is clearly covered under Aetna's guidelines. Nevertheless, Aetna denied the claim. I filed two appeals with them. The paperwork for the second appeal reached them on December 24th - the second denial letter is dated December 26th. It's obvious the denial was sent out as soon as the paperwork hit the desk. Next I filed an external review with the Department of Insurance. Aetna needed to send me any documentation they had in reference to my claim. This documentation was sent out to me, overnight. Unfortunately Aetna left my apartment number off the address; we are still searching for this package. Then Aetna promised the DOI contact person they would send it to my work. That never happened. Finally they sent the documentation out again. Again addressed incorrectly. This time they left a digit off the street address. UPS is trying to retrieve this package also. Besides that, they are incapable of keeping my address correct in their system, and my EOB's get send - you guessed it - who knows where.