I just heard from therapy place #2 today, where Chianna has been getting Occupational Therapy since January 26, 2010. They were just notified from Aetna - after over 30 days that the therapy is not being covered. Aetna states that the therapy has already been exhausted, however it has not. Occupational therapy is a separate discipline and there are separate explanation of benefits written for it. We have not used the coverage on this, I am not sure if Aetna is confused or why they would not be covering it, and especially don't know why they didn't alert either me or the therapy place sooner that they would not cover it.
I am waiting on reply from Aetna, but have to sit here in frustration and anger until they can get it resolved.
If you are reading this for the first time, this is only a piece of the puzzle and the drama that we have been put through. You can see details on this whole insurance debacle with Aetna on my blog: http://bit.ly/Chianna and if you would like to help, feel free to link to the blog and share my story with anyone and everyone who will listen. I am not just doing this for me and my family, I am doing this for all the families who have been wronged by Aetna and other insurance companies who make it their policy to deny claims in hopes you will not notice, make it hard enough to fix problems that they hope you will give up, and state incorrect things over the phone just to get you to shut up and hang up and then they do not stand behind what was said.
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2 comments:
This is insane! You almost need to quit working to take care of this bullshit! I sure hope this ends soon.
Have you filed a complaint with Florida's Insurance Commission? I often go straight to the top because I honestly do not have time to deal with this kind of nonsense. Get everything in writing, and if something they tell you doesn't make any sense or they won't put it in writing, ask for a supervisor. I often have to fight with people to get to a supervisor, (they hate when you go over their heads) but I eventually get someone who has at least a little clue what they are talking about. I think the root of all of the nations problems is that people don't want to work and take the easy way out. I recently received a bill from a doctor for Leah who she has never seen. Imagine that it was for a cancellation fee for an appointment during a time she was still in China! I have been fighting this battle for almost a year and still get bills. I found a complaint line with the State of Florida online and am waiting for the application to file an official complaint so they investigate. The amount is not that much and should I have paid it I would have saved countless hours of dealing with it. But I am doing it because I imagine that they do the same to some poor senior citizen who ends up paying it to make it go away. So hang in there, at least you have Aetna talking about the situation and some sort of modification of the way they write policies will occur.
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