AETNA NIGHTMAREDec 11 2014
AETNA is by far the most unethical organization on this planet. Due to the fact that they automatically deny all supposedly covered claims, I was forced to write and submit letters of appeal and more than enough supporting documentation from my physicians. AETNA would take up to 3 months to make a decision regarding a claim or appeal. In one incident, this caused me to exhaust my FMLA leave. Because of this, I was forced to take a leave of absence while waiting for AETNA to make a decision. In addition, they gave me and my physicians faulty advice - claiming that if I submitted a new claim using different ICD codes, my claim would be approved. In October 2013, I was employed and to my knowledge insured. Until AETNA retroactively cancelled my benefits in December 2013, and did not offer me COBRA until March 2013, after many requests. For years, I paid for top dollar for either their PPO or POS plans. In hindsight, I don't know what I was paying for because they rarely covered anything! In fact, they just delayed my required medical care and tests, worsening my condition and health. After reviewing the medical record on three separate occasions, I felt that perhaps AETNA was denying my claims due to the high amount of inaccuracies. For example, claiming I was male and not female on some pages, incorrect recording of my age, and procedures I had done. On approximately 81 out of 89 pages there were substantial inaccuracies, the most outrageous - stating I had 3 stomach tumors removed, even documenting their size in cm - I have never had any sort of stomach procedure, tumor or surgery done! When I brought this to their attention and asked that the inaccuracies be corrected, they resent me the exact same report Verbatim- with the exact same inaccuracies. I attempted filing a report with the state board insurance, but AETNA kindly reminded them that they were exempt from such review for they were an ERISA plan, and also hinted that I was violating their "policy" stating that my medical report with my name and employee number on the top of each page in the header received from AETNA no less than 3 separate occasions was potentially someone else's medical report- After numerous attempts and supporting documentation from my physicians to have my medical records corrected, I yet again received the aforementioned report along with a letter stating that after review AETNA found no inaccuracies. Needless to say, this was highly offensive, stressful, and ultimately led me to my resignation from my company. Fast forward to December 2014, I am receiving bills from my medical providers for procedures and tests dating back to October and November of last year. Apparently, AETNA is rescinding payments they made to these medical providers, claiming I was uninsured during that time. How on earth can this be possible?