Deny Claims Automatically and Wait for Patient to Quit Filing FormsMay 29 2014
Over a 2 year period I paid more than $7000 into my healthcare plan and my employer probably paid more than $15,000 on their end. In that span my family (2 adults, 11 year old and toddler ) received care approximately 25 occasions. These were regular check up visits, immunizations, and the occasional sick-visit. Of these visits. 15 were NOT APPROVED. My wife spent hours on the phone with Aetna and the Doctor to get the claims refiled with the correct billing codes. They appear to work together to deny claims so that the patient will pay the doctor\'s office directly instead of dealing with the Aetna. It is a racket. I received a call from a collection agency this week and found out that some doctor\'s office is looking for $200 for a doctor visit 2.5 years ago. Instead of re-filing the claim with Aetna, they come after me. I looked online at the Aetna list of claims to find the dozen \"not approved\" determinations. I attempted to call and to e-mail. No response. The phone line says that they are in training. It is a simple job... Press \"Not Approved\" and then record an out of message about training.