Wednesday, May 4

Aetna: Free At Last

I haven't blogged in over a month; I assure you it's not for lack of material. My computer died. Maybe I'll blog about FedEx next. For now, Aetna.

It had been over 3 weeks since I had spoken with an Aetna rep, after the pulmonologist's billing administrator had appealed to me for my help in breaking through the Aetna stall tactics. I called to follow up.

First Val informed me that they were still waiting on the pulmy's notes and the notes from the hospital where the tests were performed. I replied that the pulmy's admin had sent them the notes over 3 weeks prior and they SHOULD indeed have them. She disagreed.

I asked if she was SURE the hospital hadn't forwarded notes along. She was. I asked if she was SURE Aetna was requesting the files for the correct person (remember, until a month ago, they'd been asking the pulmy for "Jared Clarke's" chart.) She was. I asked if this was not terribly strange that after 18 months EVERYONE was ignoring her requests for information. It was, she said, "But you can't blame us!"

Well, I can, but that's beside the point. I asked her to check on something for me (I don't even remember-- that's how ridiculous and tiring these conversations get) and she returned to the phone. "Oh," she said, "I found the information we needed from the hospital."

"You DID?" I exclaimed.

"Yes," she replied, "it was here in your file, but it wasn't put into the computer properly."

"What's the date on it?" I asked.


"May 14, 2004."

May 14, 2004?! I was making this phone call eleven months after they received this information, and after ELEVEN MONTHS they were still claiming they didn't have it, desperately needed it, and were holding my $800+ hostage. You know, back in February they told the billing administrator they had found some of this information in my file that had not been entered into the computer properly, but swore it would be resolved soon. Here it was, April, and it had NOT.

Fortunately Val seemed to realize that Aetna had not only dropped the ball, but let it bounce away into traffic, and didn't even have the decency to chase after it like a small child . . . and she promised to call the pulmy billing admin and have the information faxed over ASAP so that the claim could finally be submitted with all the proper information. I thanked her, disbelieved her, and hung up.

I immediately called my now-good friend, the billing admin. I had to wait on hold because she was on a call. When she answered me, she informed me that Val had beaten me to the punch! Val actually called! Val asked for the information to be faxed over, and the admin said, God bless her, "You mean the information I already sent you?"

Two days later there was a message on my machine from Val, informing me that ALL the required info was received (and, apparently, properly logged in the system) and that the claim would be submitted for approval. I will still believe it when I see it.


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