Aetna, Inc.

Review: I have been trying to work with Aetna since last fall (2013) in getting an [redacted] approved. I have scheduled multiple appointments to get an [redacted] and very time I have to either walkout or cancel at the last minute because Aetna can not get its paperwork straight and tell me a consistent story.In one scenario Aetna approved an [redacted] but when I went to have it done the facility indicated that what Aetna approved is not what needed to be done. In another scenario Aetna told me I was approved for a facility which I made an appointment at then the night before my [redacted] I called Aetna to confirm it was in-network and was told it was not.An [redacted] cost only a few hundred dollars but Aetna can spend months giving me the run around while taking my money in premiums and failing to deliver the health care they are supposed to provide. Aetna is not only negligent and operating under business malpractice but they are also, more importantly, denying me health care.It seems Aetna is more interested in protectuing its profits than it is in providing health care management services that consumers are paying for and expect.My doctor and I have been going back and forth with Aertna for over two months. To this date Aetna has failed to resolve the 'stalemate' they have forced us into.Desired Settlement: 1) Allow me to use my insurance to get an [redacted] on my foot since that is why I pay for insurance. Aetna is micromanaging the process and through this micromanaging I am unable to get the service done that my doctor has requested. Put it in writing and honor the service they are suppose to provide. 2) Provide my company point of contact such that I can make them aware of Aetna's negligence in providing the service they are being paid to provide.

Business

Response:

Thank you for your inquiry received on February 21, 2014. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: I cancelled my Aetna Health Insurance (Group #: [redacted]) effective 12/12/13. I had paid my health insurance up until 12/31/13. I have written Aetna two times requesting a return premium for December 12 - 31, 2013. Aetna has not replied about my return premiumDesired Settlement: Return prorated insurance from December 12 - 31, 2013.

Business

Response:

Thank you for your inquiry received on March 20, 2014. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you. We reached out to the Billing department for assistance with the member’s concerns. They advised changing the termination date to December 12, 2013, as requested. They also requested a refund check in the amount of $205.68. They advised calling the member on March 20, 2014 and giving this information. Thanks.

Review: Aetna Insurance is not paying bills submitted from my doctors. My doctors keep getting the bills back with a memo they are waiting for me to contact them confirming I do not have any other insurance coverage. I have called them 4 times to confirm I do not have any other heath insurance coverage yet they keep denying my claims.

Product_Or_Service: Heath insurance coverageDesired Settlement: DesiredSettlementID: Other (requires explanation)

Please contact Aetna to resolve this issue. I am kept on hold for at least 20 minutes each time and assured this matter would be resolved; it has not.

Business

Response:

Hi [redacted],

We received the “SECOND NOTICE” email from you on 06/02/2014. We attempted to contact Ms. [redacted] for additional information needed for us to review her complaint. However, she has not replied back to us yet. We asked her for the specific dates of service, billed amounts, and provider(s) name of the claims that are being denied? Once we receive this information, we will be able to complete our review. Any assistance you can provide would be greatly appreciated.

Thank you.

Review: I have called 13 Doctors so far that I found on the Aetna "Find a Doc" webpage and so far all 13 of them have moved locations or no longer accept Aetna insurance. I called Aetna to ask what was going on, they sent me a list for my area and so far I have called 4 of those Doctors and none of them accept Aetna insurance. What is going on here?Desired Settlement: Aetna needs to revisit this. What doctors accept Aetna - This information needs to be up to date. Does anyone take Aetna in the [redacted] area?

Business

Response:

Thank you for your inquiry received on 09/15/2014 regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: AETNA has failed to process a bill from [redacted] Hospital. Despite being provided with the proper documentation and multiple phone calls from myself.Desired Settlement: Please pay this bill as I am covered.

Business

Response:

Thank you for your inquiry received on December 08, 2014, regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you. We are currently reviewing the member’s issue under case number [redacted], which was received on December 08, 2014 by our Executive Resolution Team. The member will receive a determination once the review has been completed under separate cover. We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. [redacted]’s concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]. Have a good New Year! [redacted] Complaints and Appeals Consultant Executive Response Team

Review: I switched from Aetna to [redacted] 12/1/13 with regards to health, dental, and pharmacy. My pharmacy,[redacted], was given the new information for [redacted] but accidently billed Aetna for two prescriptions, one on 12/14/13 and another on 12/29/13. Aetna in error paid both of them and then I received a bill in the amount of $230.05 in a letter dated 10/28/14, 11 months later!!! The billing ID is [redacted] and my member ID is[redacted]. When I called to ask why they were not dealing with this problem themselves they said[redacted] will not make changes after a week and they could not contact [redacted]. I contacted both and spent hours on the phone trying to get this fixed to no avail, both said too much time has passed. This should not be my problem, it should be Aetnas, especially since they waited almost a year to contact me!!!!!!! I even went as far as to call Aetna to pay the bill jus so I would never have to deal with them again and they bounced me around to 5 different locations until I finally asked for a supervisor repeatedly and they sent me to a so called "resolution specialist" who couldn't resolve anything nor could they take my payment over the phone. The letter has threatened me with collections on a bill I should not owe and I am sending in a check to Aetna today because I am moving in a few months and will need a mortgage so I do not want any hits to my credit. This should be there problem and not mine.Desired Settlement: I am paying the bill but I FULLY expect them to refund the $230.05 regardless of whether they get reimbursed by[redacted] or [redacted]. They made the error and won't fix it, I have insurance and shouldn't have to pay this.

Business

Response:

Thank you for your inquiry received on December 16, 2014, regarding complaint # [redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

We reached out to our Aetna Pharmacy Management department for assistance. They reviewed the member’s claim(s) and unfortunately, we are unable to waive the member's liability. Since the claim was paid and the medication was filled when the member was no longer covered by Aetna, the member is responsible for the cost of medication. The member may submit the claim to the correct insurance carrier for the date of service involved.

Review: I have had Aetna health insurance coverage for 14 years. This includes 4 years with an employer and 10 years as a retiree (albeit I continued working with other organizations). Thus I have been paying the monthly premiums faithfully, and because my health is good, have not had many healthcare claims submitted to Aetna. Around July last year, my current GP's office called to say that Aetna was rescinding payments made to them for my healthcare services and were pulling monies from other accounts to cover my charges. I had received no notice from Aetna that this was going to happen or why it was going to happen. But I suddenly had several healthcare providers dunning me for unpaid bills. Given that I am on fixed income, this was a heavy impact to my budget. I had to submit complaints and appeals to Aetna over several months to find out why they were taking my money but not paying for healthcare services. Aetna said it was because of my age. They did not immediately provide this in writing; a customer service rep rudely told me this on the phone. "I hadn't enrolled in [redacted]" he said and at my age I should be. So the charges they were taking back from healthcare providers were to cover what [redacted] would have covered. So now, thanks to Aetna, my credit report is in shambles and there exists the probably that some healthcare providers will sue me, thanks to Aetna's own administrative error in overlooking non-enrollment in [redacted]. Ultimately, I was paying premiums to Aetna for 14 years, which loosely amounts to some $15,000, of which probably less than half of that amount actually went to healthcare providers over that time period. So it appears to me that Aetna is punishing me for having good health--making me pay for it basically.Desired Settlement: Aetna to repay all the healthcare providers who have provided services for me and from whom they have rescinded funds.

Business

Response:

Thank you for your inquiry received on 02/05/2015 regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

The member’s concerns were reviewed under appeal numbers [redacted] and [redacted]. Based on review of the information submitted, the appeals were upheld per the plan guidelines. Under the terms of the member’s plan through [redacted], Aetna estimates [redacted] benefits in accordance to the provisions of the plan. [redacted] pays before [redacted] coverage for a person who is over age 65 and retired, or who is under age 65 and has received Social Security disability benefits for 24 months. [redacted] benefits will be taken into account for any person while he or she is eligible for [redacted]. This will be done whether or not he or she is entitled to [redacted] benefits.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].

Review: Aetna offers a [redacted]. After using the plan, we quickly realized we could not get service for our son because he is over the age of 6 requiring pediatric work. We contacted Aetna to obtain the required authorization number & referral for a consultation with a pediatric dentist so they can determine what work our son would need. We gave both to the in network dentist. We made an appointment with the dentist. On the day of the appointment, the dentist informed us that we cannot see the pediatric dentist because our son is over the age of 6. We are paying for dental insurance and cannot receive care for our 8 year old son who requires 2 spacers and some fillings.This greatly affects the dental health & health of our son.Desired Settlement: We would like a refund for all of our son's portion of the dental insurance since we chose this [redacted].We would like Aetna to appologize and remove this in network dentist from their [redacted]. The Dentist is [redacted] located in [redacted] and [redacted].We want an explanation in writing as to why we cannot receive a consultation and treatment for pediatric work for our 8 year old son.

Business

Response:

Thank you for your inquiry received on 02/26/2015 regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: I have contacted Aetna about bills due on my sons pediatrician that were not billed correctly. They stated the problem would be fixed by 7/28/2014 by an aetna employee.. They were not. I spoke with [redacted] at Aetna on 7/31/2014 when I realized the problem was not solved and faxed her all of the bills that were not paid. Throughout 2014 I have tried contacting [redacted] K. at Aetna about this issue and it keeps getting diverted some way. On 8/7/2014 I had to re-fax everything to her again for a "meeting". She was supposed to call me back by 8/13/14 and did not. I called again on 8/27/14 and the issue was still not resolved, and again on 1/9/15 with the same outcome. The hospital has re-billed these to Aetna TWICE and they still have not fixed them.Desired Settlement: I just want all of the hospitals re-billed payments to be corrected. It's a lot of money that I do not have and would like it to be fixed ASAP.

Business

Response:

Hello,

Review: Aetna did not cover entire claim. Employee misled me and stated (before I purchased the medication) that I would be reimbursed the difference between what I normal co pay ($1.20) and full amount Rx cost (74.99).

Aetna paid -

49.68.

I paid -

25.31

My co-pay for medication is $1.20. Atena owes me $24.11.

If company does not comply with the Revdex.com mediated service, I will be releasing the phone conversation I had with their representative, on public forums, via 4 television news affiliates. The representative clearly stated that I will only be paying 1.20 for co pay and will be getting the difference between the co pay and full price of 74.99 back.

Other requests - Aetna employees do not know how to do their jobs. I requested to be opted out of selling my information to other companies/businesses and not one person knew how to carry the action out, which Aetna needs to do.

Created online profile and I need to change my username and your system does not have an option to do it.

Selected paperless statements, but when I log back onto account, your unstable system states that I am still enrolled in paper statements. Aetna is not an eco-friendly company and is killing millions of trees for the sake of sending paper statements customers don't want. Change my account to paperless statements immediately.Desired Settlement: Aetna did not cover entire claim. Employee misled me and stated (before I purchased the medication) that I would be reimbursed the difference between what I normal co pay ($1.20) and full amount Rx cost (74.99).

Aetna paid -

49.68.

I paid -

25.31

My co-pay for medication is $1.20. Atena owes me $24.11.

If company does not comply with the Revdex.com mediated service, I will be releasing the phone conversation I had with their representative, on public forums, via 4 television news affiliates. The representative clearly stated that I will only be paying 1.20 for co pay and will be getting the difference between the co pay and full price of 74.99 back.

Other requests - Aetna employees do not know how to do their jobs. I requested to be opted out of selling my information to other companies/businesses and not one person knew how to carry the action out, which Aetna needs to do.

Created online profile and I need to change my username and your system does not have an option to do it.

Selected paperless statements, but when I log back onto account, your unstable system states that I am still enrolled in paper statements. Aetna is not an eco-friendly company and is killing millions of trees for the sake of sending paper statements customers don't want. Change my account to paperless statements immediately.

Business

Response:

Can you please request either the member’s ID number or Date of Birth to be able to start an investigation for this complaint? We are not able to locate him with just his name and zip code search. Thank you,Ashley

Review: I pay for insurance, through my employer, and the cost is over $300/month.

The insurance I pay for has been active since 1/1/2015.

However, we did NOT get our policy numbers until 1/12/2015 and we had to forgo medications and medical care during this time UNLESS we wished to pay out of pocket. Some people cannot pay out of pocket for these services and I am one of those people.

Currently, I cannot get prescriptions filled because Aetna reps keep telling me there is a coding error. On 1/26/2015 I was told that the error would be resolved within 72 hours.

I waited past that time to contact them again and called back on 1/30/2015

STILL, my policy, which includes medications, CANNOT BE USED for medications! I cannot fill prescriptions at the pharmacy even though my plan shows I have coverage! NO ONE can help me. All they keep saying is that I need to pay, out of pocket, for my medications. I cannot afford that.

I pay for insurance so that I do NOT have to pay out of pocket for medications.

The answers I am getting from Aetna are unacceptable and not helpful.

I need my medications now and I cannot continue to wait. Their service is shoddy and they are not providing what I pay for.Desired Settlement: I want to be able to GET my medications, at the pharmacy, the way I am supposed to.

I want them to fix it IMMEDIATELY and not continue to make me wait.

They have screwed up from the set up of this policy and their incompetence should not be my headache, but it is.

I want them to issue an apology and fix the plan so that my medications can be obtained.

Business

Response:

Please see our response to the complaint # [redacted] for [redacted] received on February 13, 2015.

Review: I received a letter from Aetna in early May this year stating that, due to the ACA, between May and December of 2014, that if I paid out of pocket for smoking cessation medicine that I was due a refund. Before I even went to my Dr. for smoking cessation counseling, I questioned Aetna through secure messaging in May if it was covered by my plan and the person who responded stated that both the couseling and the medication were covered 100%. When I filled the Rx the first time and I had to pay for it, I called in to Aetna to find out why and they stated that medicine wasn't covered.

Fast forward to present day, I filed the reimbursement claims as directed to do by Aetna and they have denied it stating that, the first time filling the medicine, wasn't covered by the plan (which the letter I received stated that I am due a refund if I paid out of pocket) and the following refills were denied using the reason of being refilled too soon. I have the written proof from Aetna, letters and secure messages, stating that everything is covered 100%, at no cost to me yet I've had to pay out of pocket. And I am unable to be reimbursed because they have a different reason every time I speak to them as to why it won't be accepted.Desired Settlement: The business should reimburse me as they have stated I am entitled to.

Business

Response:

Hello,

Review: I had applied for health insurance in Nov. 2013 for effective date 1/1/14. I was approved and Aetna collected the first months premium. After reviewing the coverage I chose to cancel and select a new policy with a lower deductible. I sent a cancellation on Nov 13. I was charged for another premium in Feb. 2014. When I called the representative stated the policy had not been canceled. She stated she would cancel the policy effective 1/1/14 (voiding my policy). I have made repeated calls to receive my refund for premiums. I have been told the refund has been processed and should be in my account. I have not received my refund and I have waited more than 2 weeks since the process date.Desired Settlement: Full refund of the $744 premium payments on a voided policy.

Business

Response:

Thank you for your inquiry received on February 26, 2014. Our [redacted] Team researched your concerns, and I would like to share the results of the review with you. We reached out to the Individual Billing and Enrollment department for assistance with the member’s concerns. They advised a refund of $744 was placed back into the member’s account on February 13, 2014.

Consumer

Response:

Review: [redacted]

I am rejecting this response because: I have been reviewing the account the premiums were taken from and no credits have been made to my account. I have patiently waited for my premium refunds. I have been in contact with Aetna customer service for a month and still have not received the refund I was told would be coming. I have attached two files from current activity on my account (the same account the Aetna premiums were debited from). These prove the refund has not been credited. I printed the entire activity from 2/10/2014 to current. I have taped paper over the balances and transaction amounts for my privacy.

Sincerely,

Business

Response:

Thank you for your inquiry. We again reached out to the Individual Billing and Enrollment department for assistance with the member’s concerns. They advised a refund of $744 was placed back into the member’s account on February 13, 2014. They advised the account on file is [redacted] with an account number ending in [redacted].

Review: My wife ([redacted]) on numerous occasions contacted your organization to request that you list [redacted] be listed as her PCP. Over several MONTHS, your organization repeatedly sent her an insurance card with an unknown doctor listed as her PCP. Your response to my wife each and every time she requested that you updated it, was to send her the exact same insurance card with the unknown doctor listed as her PCP. To make matters worse, when she went and had a doctors appointment with her PCP ([redacted]) she paid the required $20.00 co pay. Your organization decided that it was best to charge her as a specialist visit and bill her $30.00, creating a balance of $10.00. We then attempted to dispute the additional $10.00 on numerous occasions. The final attempt was in January where I spoke with [redacted]) who ensured me that this situation was resolved.Here we are nearly a year after the appointment and I still have a bill stating that I owe you money.Correct this issue and compensate us for the time invested.Desired Settlement: $10.00 removed off of the bill from 7/29/13 and compensation for your companies complete ineptitude.

Business

Response:

Thank you for your inquiry received on 06/01/2014 regarding complaint# [redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

We were unable to locate Mr. and Mrs. [redacted] in our system with the information provided. In order for us to review, we require the member’s Aetna identification number the claim was billed under. Once this information is received, we can then review for the member.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. [redacted]’s concerns. If you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted].

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

Review: I am a provider and I billing aenta better health of [redacted] for one of my patients. I submitted my claim and was told it would take up to 30 days to process. I called every other day in fear they were not even working on any of my claims. Well I was right. Not only did they start my claims on the 29th day (Dec. 9, 2014), they underpaid 45 of my claims. This is uncalled for, for a company of this size. Things like this shouldn't happen. Also every time I ask to speak to a supervisor, one is never around to take calls. They take my information and state a supervisor will call me with in 24-48 hours. The thing is I never get a phone call from a supervisor. I will also file a complaint with the [redacted] as well as the [redacted] dept of [redacted].Desired Settlement: I would like to get paid my correct amount as well as whoever worked my claim fired.

Consumer

Response:

Review: We live in CA and were in MN during the summer when my husband came down with pneumonia. I called Aetna and they said since there were no in-network facilities we would have to go to another facility and be sure it was during urgent care hours. We did that and then for the last 2 1/2 years I have spent 20 hours on the phone with Aetna trying to resolve this and get the bill paid. Every time they are polite and claim that the issue is resolved. And then a month or two later we get a letter stating that the bill is still due. This has happened 5 or 6 times.Desired Settlement: We would like Aetna to pay the bill from [redacted], MN. regarding the July 14, 2012 visit.

We would also like them to get organized so they don't waste years/hours of people's lives and cause undue anxiety. We would also like them to stop telling people that issues are resolved when they are clearly not resolved.

Business

Response:

Thank you for your inquiry received on December 12, 2014, regarding complaint #[redacted] from [redacted] concerning the claim for her husband, [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: This situation involves [redacted] Pharmacy as well as Aetna Insurance. From January 2013-September 2013, I had Aetna insurance through a previous employer. I had told [redacted] that as of October 2013, I no longer had Aetna insurance and not to process my medication through them. They were aware that I would be paying out of pocket till my new insurance kicked in.The medication was filled on 11/15/13 and picked up by me 11/16/13. Fast forward to October 2014, I received a bill in the mail from Aetna to pay $179.78 for a medication that was filled a year ago. I called Aetna to inquire further about this issue since I no longer had/have health insurance through them. They stated " we are doing audits and you must pay this bill because [redacted] submitted a claim to us when you were not an active member." I questioned them why they approved the claim since I was not an active member. They are blaming not only [redacted] but also my previous employer's health insurance representative for the mistake. I made Aetna aware that I had already paid for the medication and besides that it has been almost a year and I am only now hearing about this. I then took it to [redacted] who is placing blame on Aetna for processing the claim. Neither company wants to accept the blame therefore, I have to pay for their mistake. I have the receipt from [redacted] that says the amount I paid for it and also that the claim was rejected. [redacted] will not assist me with this issue because it has been over 6 months. I spoke with 2 different customer care representatives from Aetna who were very rude and unfriendly. There was only one representative that actually attempted to help me and listening to my situation without interrupting me.

Product_Or_Service: Medicaton_[redacted] Account_Number: [redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

1. For Aetna, [redacted] or both take responsibility for the mistake2. Since it has been over a year since issue has occurred that I do not have to pay for their mistake3. An apology from both companies for the headaches they have caused due to this situation particularly Aetna for their poor customer service

Business

Response:

Thank you for your inquiry received on November 25, 2014, regarding complaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: Was notified several months ago that my insurance coverage would be cancelled with Aenta due to the Affordable Care Act(ACA) and that unless I selected another plan that I would no longer be covered. Having received unsatisfactory service and effort from Aetna previously I found coverage else where. I saw on January 9-10th of 2015 that Aetna had debited about $227 from my checking account. At no time had a contact Aetna to continue coverage or to select a new plan. At no time did I authorize them to debit any new amount from my account. I contacted Aetna through their online complaint form and have not received any communication from them.Desired Settlement: I would like the debited amount, that was never authorized, refunded in full, and any coverage, that I never agreed to or signed for or that was ever explained to me, to be cancelled retro active to 1/1/2015.

Business

Response:

Please see our response to the complaint # [redacted] for [redacted] received on January 21, 2015.

Review: For 6 months I have been unable to use my health insurance at my [redacted] Aetna requested paper work from [redacted] Clinic to continue my care. Dr. [redacted] says the paperwork has been submitted and Aetna continues to deny having received it. I have not been able to get relief from my pain, even though I am paying for health insurance. I have pain [redacted]. I should not have to wait six months to clear this up. I am asking for your help to fix this matter, since Aetna does not seem to care about the issue.

Account_Number: wXXXXXXXXX

Desired Settlement: For Aetna to resolve the issue so I can continue to use my benefits that I have worked hard for. My pain causes me to not enjoy life as I should. I want to be able to use my health benefits as they are stated in my contract.

Business

Response:

Business Response /* (1000, 5, 2013/07/30) */

Thank you for your inquiry received on July 16, 2013. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

We reached out to the Claims department for review of the member's issues. They advised looking at claims for this member, the last date of service for the provider, Dr.[redacted], was January 3, 2013. All claims billed from this provider have been processed and paid. No claims were ever pended nor do they have claims requesting more information from the provider. Also, they have not received any information from the provider about this member.

They also reached out to the Clinical Care Review (CCR) department, to see what information they have on this member and her claims (if they have been reviewed for medical necessity or if they have received medical records). They were also not able to locate anything on this member nor have they done any reviews.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the chance to address these concerns. If you have any more questions about this particular matter, please contact the Executive Resolution Team at [redacted].

Consumer Response /* (3000, 7, 2013/08/05) */

(The consumer indicated he/she DID NOT ACCEPT the response from the business.)

This response does not address my concern.

Aetna response says all my claims are paid, but that is not the problem. As I previously stated, Aetna has told me over the phone twice, that if I go to the [redacted], my visit will not be covered. I am paying for health insurance, but unable to use it to address my back issues. Aetna is telling me I have no unpaid claims, no kidding! Why would I go to the [redacted] and pay out of pocket, when you have already told me it will not be covered?

I will accept Aetna settlement when they allow me to use the health care I am paying for. I want to be able to go back to the [redacted] and ease my back pain.

Business Response /* (4000, 9, 2013/08/21) */

Thank you for your inquiry received on August 7, 2013. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

We again reached out to the Claims department for review of the member's issues. They advised nothing showing in our systems where the member was told they could not move forward with having [redacted] services rendered. The plan benefits for [redacted] are up to a maximum of 60 visits per year and at the 25th visit claims will hold for review (we will request medical records from the provider performing the services and the Clinical Claim Review (CCR) department will determine the medical necessity of the services going forward. This is the same with Short Term Rehabilitation. Massage and Acupuncture are not covered on the member's plan.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the chance to address these concerns. If you have any more questions about this particular matter, please contact the Executive Resolution Team at [redacted].

Review: Aetna has ignored my attempts to cancel an application for health insurance that they deemed "incomplete", and placed a pending charge on my credit card, disregarding my numerous cancellation requests. The application was processed through [redacted].com, where my credit card information was required up front. The application stated that my card would only be charged if the application was approved. I received an email from [redacted] stating that Aetna deemed my application "incomplete". I attempted to reach customer service multiple times for assistance with how to complete the application. After receiving no response, I emailed [redacted] at [redacted].com to cancel my incomplete application. Meanwhile, I took out health insurance with another company. Several days later, I receive an email from both [redacted] and Aetna that my incomplete application is suddenly "approved" and that my credit card will be charged. I phoned [redacted] at ###-###-#### to repeat my wish to cancel the incomplete application. The lady hung up on me. I then emailed both [redacted] and Aetna repeating my cancellation request. I called Aetna billing at ###-###-#### and repeated my cancellation request. The lady told me that they have already placed a pending charge on my credit card. I asked to cancel, and she said they "usually go through with a pending charge". I insisted that I NOT be charged. I called my credit card company, and they said until the charge actually goes through, they cannot be of assistance. Both Aetna and [redacted].com have displayed terrible customer service by ignoring my requests 1st for assistance, and then to cancel the application. They have threatened unauthorized charges to my credit card by refusing to honor my request to cancel a health insurance application that they initially deemed incomplete. Ignoring repeated cancellation requests is an unacceptable business practice.Desired Settlement: Refund if the unauthorized charge appears on my credit card as Aetna has threatened. I would also like an acknowledgement of my cancellation by Aetna and [redacted] in writing so that I can be assured of no future charges.

Consumer

Response:

From: [redacted]

Sent: Wednesday, December 04, 2013 10:51 AM

To: Revdex.com

Subject: #[redacted]

Resolved. I received an email of cancelation from Aetna.

Thank you for your help.