Sign in

Aetna, Inc.

Sharing is caring! Have something to share about Aetna, Inc.? Use RevDex to write a review
Reviews Aetna, Inc.

Aetna, Inc. Reviews (441)

Review: We are a small medical practice with less than 10 employees. For over 5 years we offered our employees group health benefits after successfully completing a 90 day probation period. When adding one of our employees on Nov 20, 2014 for enrollment on December 1, 2014 to our group plan with Aetna online, the system automatically reverted the day back to November 1, 2014 and now Aetna has sent us to collection for a month of health benefits when 1) THere are no outstanding claims 2) Our internal employee policy is a 90 day probation period. We were Aetna's customer for many years and do not understand how a reputable company like this would use such low tactics to increase their revenue. Doctors are already struggling with declined reimbursements and we certainly do not appreciate this lack of professionalism and poor business ethics. Both my insurance broker and I have tried to communicate with Aetna, but there appears to be no one willing to help us on this matter. The amount oustanding is $590. There collection agent [redacted] keeps calling and sending emails. All over $590!Desired Settlement: We paid our premiums punctually in the past for over 5 years. We honestly do not believe we owe Aetna any monies. They imposed a 60 day waiting period in the system to benefit for an additional montly premium when our policy is a 90 day probation period to become eligible for health benefits. As a small medical practice, we are appalled and the behaviour of this insurance giant. Grateful for your assistance with this matter,

Business

Response:

Hello,

Thank you for your inquiry, 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.

Upon receipt of the complaint we immediately reached out to the member and emailed her for more information on November 04, 2015, so we could investigate the complaint. Unfortunately, at this time we have yet to hear back from Ms. [redacted]. If she wishes to pursue this complaint further please have her email us the following information to the email below. We need the employee’s full name, DOB, as well as the medical office/group name this is related to.

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

Thank you,

Ashley S.

Complaint and Appeal Consultant

Executive Resolution Team

Consumer

Response:

Dear Ashley S.Re: Complaint [redacted]Please note I have not received any messages from Aetna direcly to solve this situation. All the calls I have received have been from the collection agency. However, here is the information requested:Employee Name: [redacted]Date of Birth: [redacted]Employer: [redacted] Aetna Account Number [redacted]Thanks for your prompt response. [redacted]cc: Revdex.com

Review: Since December 2014 I have had to make numerous calls and inquiries to Aetna to get my benefits paid correctly. I went through their precertification process and received written approval to have my health services covered as in-network at the highest rate. I have had to make more than 20 calls and sent several emails and I still am unable to get them to process my latest claim from 1/26/15 correctly. I have an email from them telling me that they made mistakes and are reprocessing and today when I checked it is still not correct. It is completely unacceptable that they run their business this way, every claim form I submitted has my case number for pre-approval and the letter they provided me with and they still processed wrong. After many calls I was told my account was marked for 'manual processing' to ensure it would be correct for the future and it is still wrong. There is absolutely no excuse for them to process these correctly when I did all the pre-work to ensure it was correct beforehand. I have hours of my time trying to get them to do their job.Desired Settlement: I want them to do the job I am paying them to do and process my claims correctly.

Business

Response:

Hello,

Thank you for your inquiry, 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.

Upon receipt of the complaint we immediately reached out to the Claims department to have the date of service January 26, 2015 reviewed. We were advised that it was originally processed incorrectly and we had the claim reprocessed correctly under the member's plan. The member's policy was set up for manual processing on February 21, 2015 so that future claims will drop to a processor for handling.

Please accept my apology for the delay in processing the claim correctly, and that it required multiple attempts on your part to resolve your issue. Unfortunately, in some instances, procedural errors do occur. When they do, we take them very seriously and do our best to understand how and why the errors occurred and determine what we can do to prevent a recurrence. We continually use feedback like yours to improve our service and prevent issues from reoccurring.

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

Thank you,

Consumer

Response:

Review: [redacted]

I am rejecting this response because:

Review: Aetna is refusing to cover my medication and when I have called I get one representative and they tell me that my medication will be covered then they talk to the people in the Pharmacy part of Aetna im guessing and they state that My Employer is not paying for my medication my employer has noting to do with me getting my medicationDesired Settlement: I need and want my medication at the price I was told that it was going to cost me that’s what I would like the outcome to be

Business

Response:

Please see our response to the complaint # [redacted] for [redacted] received on January 23, 2015.

Review: Shortly after the 2nd of January I started looking for immunization clinics because I am starting on a world wide journey tomorrow (February 2nd). I proceeded to call my insurance company (Aetna) and ask them if this would be okay and what was covered. I talked to a lady, but did not get her name (I just thought it was a routine question). I explained the clinic and what I was doing at the clinic. She proceeded to tell me that "Yes, you are covered. For out of network clinics, you pay 20% and we will pay 80%." I thought wow, okay that is awesome! I proceed to get all of the shots for [redacted], and [redacted]. My first visit cost me $1075.00 out of pocket. My Second visit cost me $80.00. The third visit cost me $325.00. So coming to a total of $1,480.00. I was expecting to get a check for 80% of the cost, which would have been $1,184.00. I submitted all of the claims and waited to hear back. I didn't hear anything back from them so a few days ago I called to confirm all the information. When I asked the guy I was talking to, he told me my claim had been denied. When I asked him why, he said the clinic wasn't covered. I proceeded to tell him that I had called before I even went to the clinic to make sure that it was covered and I had been told it was. I stayed calm, but I was very worried. I am a 22 year old girl who has a limited budget. For me it was eating and not eating. Having a place to sleep. It wasn't just $1,200.00..it was my livelihood. I know the people on the phone can't always do much, so I asked if I could speak to a manager. He proceeded to tell me she wouldn't tell say anything else. When the manager got on the phone, she has such a cold, callous voice. You could tell she showed no ounce of sympathy. She continued to tell me there was nothing I could do, but she could file an appeal. I said couldn't you listen to the call? I know it was recorded. She said they would listen to the call and I had to wait 30 days.Desired Settlement: If there is anything you can do, I would be so very grateful. I will be leaving the country tomorrow morning at 6am. All this is happening at the worst time, which makes it all so much harder for me to deal with. I will have access to the internet sporadically. My email is [redacted]. My global phone number is [redacted]. I also have a blog you can check out if you are interested. [redacted].

Business

Response:

Thank you for your inquiry received on 02/01/2014 regarding compaint #[redacted] for [redacted]. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: After January 20, 2014. I received every single week at least 7 or 8 letters from AETNA with ID cards, most of these ID cards have my name, with the ID , health plan, place of employment and type of insurance of other person. Also ID cards with mixed information (my ID information and health plan with the name of other person); in other cases the ID cards of other people with their personal information. in envelopes that have my wifes name and our address, and in other cases the envelopes have somebodys else name with my address, and inside I found my information or other people's insurance information. Just a few of these letter have our name on the envelope and our correct ID cards. I ignore most of the letters, however the frequency and all the mistakes made me concern about my personal information being delivered to somebody else. I called AETNA on February 24, 2014, and inform the costumer service representative about all these issues, she inform me that she will get this resolved and just to disregard any other letter received during the next week.After that I still receive 8 letters weekly with the same issues, I called AETNA on 3.7.14, the costumer service rep that took my call told me that she did not found any previous report about my id cards, and that she will take care of it.She did call me on 3.11.14 to ask me about the information in the ID cards, and told me that she will take care of it, in these 11 days I received more than 16 letters, all showing the same issues that I described before and until now I have no idea how many people receive my personal information in their mail, and I'm still getting other people's information in envelopes that have my wife's name and our address.Desired Settlement: I want an answer from AETNA, stating if my personal information was delivered to somebody else or not, I dont want to receive more mail with other peoples information, an apologize and a possible economic compensation for all the time that I spent and stress that these issues caused to me and my wife.

Business

Response:

Thank you for your inquiry received on March 24, 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 Aetna Student Health (ASH) department for assistance with the member’s concerns. They advised an error in their system caused the issue with the ID cards. They advised correcting the issue and the member should not receive further incorrect information. They have also advised the Privacy Compliance department to investigate the privacy concerns. We apologize for the issues and inconvenience this has caused the member.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is partially satisfactory to me. I wan´t to receive answers about the security of my personal information from AETNA

Sincerely,

Review: received a letter in the mail stating that Aetna had dropped my health insurance as per my request. I never requested. After 2 days of phone calls with 4 hours of wait time via the phone a service representative stated that the letter was a mistake and I could dispose of it ??? It was because the Affordable Care Act was forcing me into a new plan and I was no longer grandfathered in. She continues to state that it will be $1004.00 per month with $6,000 for each person deduct. with 100% pay until reach of deductable. I stated that this was UNACCEPTABLE . She stated that I would have to speak with someone in sales and that the last day to change from this New plan was the 15th! She then transferred me to the "sales" department and dropped my call ! I phoned again spending 2.5 hours on hold with no answer. I phoned again 3 hours on hold no anwer. Over the next three days I called and called and called on hold NO ANSWER!! I searched the Internet looking for every number for Aetna , I called them all , either disconnected or on hold with no answer !! This evening one of the numbers yielded a switchboard operator , she was extremely rude with no regard for my situation , provided no customer service said she would transfer me to "sales" and she promptly hung up ! After 6 days and 14 hours of hold NO RESULT!! they will automatically enroll me into that expensive no coverage plan with NO OPTIONS !!!! This feels like to communism/socialism .Desired Settlement: To be able to speak with someone to place me into the appropriate Health Insurance plan for my family !! We've had great health insurance for 30 years , why is AETNA trying to force us into a plan that is OVER THE TOP EXPENSIVE INSURANCE PLAN WITH NO BENEFITS !!!!!!!

Business

Response:

During our review, we reached out to our Enrollment department to address [redacted]’* concerns. However, [redacted]’s information was not found in our system which required [redacted] to be contacted.An outbound call was placed to [redacted] by our Enrollment department so we could address [redacted] concerns. However, there was no answer from [redacted], so a detailed voicemail was left including the nature of the call and a direct call back number ###-###-####. This way [redacted] may call our Enrollment department directly so her concerns may be addressed.I apologize for any difficulties or confusion this may have caused [redacted]. We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted]’s concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted]Regards,Julian C[redacted]Executive Resolution Team

Review: My complaint does not involve a health issue directly but rather nonpayment of insurance by Aetna. I am covered under a group Aetna policy through the [redacted] Aetna is my secondary insurer. I submitted a group of pharmacy bills back in April for payment under the Co-ordination of Benefits portion of my policy. Aetna has made a partial payment, applying the payment as if they were primary insurer. I have called them 3 times, been assured someone will call me back, and there have been no call backs. I resorted to emails - 2 of those without marking on their site that my complaint was "formal" and the last time stating it was a formal action. It didn't make any difference whether it was formal or not formal - all I get is a form letter saying they are investigating. I've run out of patience.What I want is a copy of the COB portion of my contract along with an explanation of how they arrived at the amount of their payment. Neither request should be difficult for them.Desired Settlement: What I want is a copy of the COB portion of my contract along with an explanation of how they arrived at the amount of their payment. Neither request should be difficult for them. Alternatively, they can adjust the payment amount to what it should be and send me a copy of the COB for future reference.

Business

Response:

Thank you for your inquiry received on September 17, 2013. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: In November of 2013 I tentatively signed up for aetna insurance to start in January 2014. It was tentative because I really wanted to check out Obamacare but was having trouble accessing the website. The Aetna service rep told me that I could call to cancel at any time.I cancelled in November. On December 5th Aetna took $263 out of my checking account for this insurance which I had cancelled.I called member services and spoke with someone who told me I would be getting a refund of the $263 in the mail. I explained to her that I had incurred a $35 overdraft fee because I didn't anticipate this deduction. It was paid to Aetna because I have od protection, but I still had to pay the $35 fee. The rep told me that to get the $35 back I needed to mail a copy of the bank statement and a letter to aetna....which I did.I still have not received a check from them. I did receive a statement noting a $263 credit, but no check. I haven't heard back about the od fee at all. I called member services again on December 27th and spoke with an "[redacted]". She said there is no record of such payment from me and that I should call another number which she gave me. After being on hold for 30 minutes and never speaking with anyone...I hung up. I also had 5/3 bank fax a copy of the od statement to them because [redacted] told me to do that. The fax cost me $5. I tried calling again today but got the recording, "We are experiencing a large call volume." I held for 15 minutes and then hung up. So, now I am writing to you.Desired Settlement: I want a check for $303. $263 for the premium refund, $35 for the overdraft fee and $5 for the fax. And I want it asap. This has gone on too long.

Consumer

Response:

From: [redacted]

Sent: Thursday, January 02, 2014 2:33 PM

To: [redacted]

Subject: Re: You have a New Message from Revdex.com Serving Connecticut Regarding Complaint #[redacted]

Aetna did deposit $263 into my checking account this morning, but they have not paid the $35 fee caused by their incorrect deduction or the $5 fax required by their customer service rep.

Business

Response:

Thank you for your inquiry received on December 30, 2013. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: I was terminated from my health insurance plan without proper notification or threat of termination. I received a final termination notice only. No email, no phone call, and no mail except for regular monthly bills. The last bill I received I went to make a payment online and Aetna online pay center was offline and I was not allowed to make the payment. I then forgot about the bill because I always pay my bills when I get them and it slipped my mind with a busy work schedule. When I get a termination notice without any prior warning, not even a warning on my last bill I was astonished. How could this be? To make things worse they sent the mail on Wednesday 11/27 and I recieved it on Friday 11/29. The significance of this is Thanksgiving was Thursday 11/28 and they were closed til Monday 12/2. How was I supposed to get in contact with them. They found a way to get rid of me like they will with everyone so that they can start charging the higher premiums that The Affordable Care Act will allow them so that they make more money off of me. I have paid my past due balance since and while on the Aetna site it still shows my termination. Please correct this! This is a blatant abuse of power.Desired Settlement: I want reinstatement of my plan benefits and a solution for their archaic bill pay system.

Business

Response:

Thank you for your inquiry received on December 3, 2013. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Review: On May 11,2015 I received a check for $1,950.00 from Aetna Life Insurance Company via a company named [redacted] Card Services Inc. I deposited it into my bank and was contacted a week later by my bank stating the check was counterfeit! This was after I paid my rent and other bills. I have contacted Aetna MANY times to be told "we are looking into it". Meanwhile my good standing with my bank of 3 yrs is gone, and I cannot get another bank account.I need help getting this resolved asap pleaseDesired Settlement: I would like Aetna to put the monies into my account electronically (do not trust checks anymore)to include fees Also no derogatory affect with my bank Thank you

Business

Response:

Hello,

Review: Aetna states I owe them reimbursement for LTD benefits after awarded SSDI. All paid-now 2 years later they say I owe additional.

Aetna provided LTD payments through my employer, UPS, from March 2010 through February 2011. Aetna contracted with [redacted] to help with awarding of SSDI and then to collect over-payments after I was paid back SSDI payments. This was collected by Allsup and this sum is not in dispute.

My disabled son received an increase in his SSI payment (now collecting under my benefits). [redacted] collected $5,373 on 3/22/11 via credit card for payment of child's increased award. On 4/16/2013, I received a letter from Aetna stating that the total owed was $5, 623.50 and that my current outstanding balance is $3,774.25. I sent proof of payment and asked for additional documentation. None provided. Now sent to collection agency [redacted] and is reported on my credit report. Documentation of payment was also sent to collection agent [redacted]) on June 24th, along with written notification of disupute. I had been told this would not be reported to credit agencies while it was in dispute. Also note that this request came over 2 years from actual payment.

My accountant has also reviewed-this involved complex tax returns for affected years, and he believes Aetna is in error.

Desired Settlement: I am requesting that Aetna review their records and provide sufficient documentation of the the charges it seeks to collect. I have paid everything through [redacted] as requested and have documentation of all correspondence and payment. [redacted] believes there should be no problem and they paid Aetna. If Aetna believes it was not reimbursed appropriately, [redacted] or Aetna itself is responsible for the error. Collection activities must cease.This incorrect information must be removed from my credit file.

Aetna disability claim case #: XXXXXXX.

I

Business

Response:

Business Response /* (1000, 5, 2013/08/06) */

Thank you for your inquiry received on July 23, 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 Disability department for assistance with the member's concerns. They advised the member's file was overpaid on two separate times:

1. December 10, 2010 for Primary Social Security, $20,054.50 gross/$16,280.25 net (if paid in 2010).

2. For Family Social Security, $5,623.50 gross/$5,373.30 net (if paid in 2011).

For the Primary SSD, since the overpayment wasn't paid in full in 2010, the full gross amount was due $20,054.50. [redacted], our Social Security vendor, recovered $16,149.00 on

January 21, 2011 and $131.25 on February 7, 2011, leaving a balance of $3,774.25 on the Primary SSD overpayment.

The Family SSD, [redacted] recovered $5,373.30 on April 5, 2011, recovering the overpayment due to Family SSD in full. Since the overpayment occurred in 2011 and was reimbursed in 2011 the net overpayment was due.

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, 2013/08/12) */

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

I had a long-term disability policy through my then employer [redacted]. It provided a defined monthly benefit. When I was approved for Social Security disability payments, I received a lump sum from Social Security retroactive from the date of coverage. I repaid Aetna every penny of the amount I received from Social Security. I have provided documentation of this payment. I do not understand why I have to repay more money than I was reimbursed by Social Security. Isn't that the purpose of the disability plan?

Business Response /* (4000, 9, 2013/08/28) */

Thank you for your inquiry received on August 14, 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 Disability department for assistance with the member's concerns. We were advised that [redacted], Senior Technical Specialist at Aetna called and spoke with the member on August 20, 2013 and tried to address his concerns. She advised the member needed to review his lump sum payment from SSD and verify whether or not taxes or any other deductions were taken out as Aetna has to calculate the overpayment based on the gross monthly award. The member understood and stated he would review his SSD payments to verify if taxes or any other deductions were taken out.

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: Revdex.com info braces

I need help here, or I am stuck for life in these braces that they Aetna are responsible for the care and treatment for full completion.

finish the job

Complete resolution care and satisfaction to complete the care and services and obtain the initial desired goal and treatment that was assessed and diagnosed upon services. My desire is to fully complete the services for braces and obtain the goal set out to that was explained to me by dentist that rendered me care. Their expertise expressed to me that this is what they recommended to me. Aetna gave me all of the contacts to call for services within the network, and their rep gave the ** permission to treat via phone prior to their services.Desired Settlement: Complete the work and fully refund me for my monthly and out of my pocket fees and full reimburstment to me and with Aetna paying for the full completion of my braces in full without charges to me at all, due to the companies inability to resolve this matter with many attempts from me to many of their staff via calls. I need help here.

Business

Response:

Thank you for your inquiry received on November 17, 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: I was injured in a motorcycle accident on the 25th of April. I have [redacted] which I still am experiencing symptoms from.\par I have short term disability through work.\par I have seen one check from them that was for the complete amount for the total amount that I was owed for. I should be receiving individual checks, which should have started from the 25th of April. On May 30, 2013, they deposited $1231.32 into my account and there was no breakdown provided of what they are supposed to be paying me.\par I had to see my Doctor on May 28th for the same issues from the accident. According to my doctor, I will eventually have to have another surgery. Myself and the doctors office went through all the proper channels and sent in the requested paperwork to keep my payments coming, because I am still too weak for surgery at this time. \par I called the company this morning, because I didn't receive a check. I found out from the representative that they closed my case. No one called me, no letters received, no notification was given informing me that they were going to close my case. My case should remain open as I am still under doctors care.\par I feel this company is not professional and not providing me with quality customer service or assistance. This company lacks professional business ethics in customer careDesired Settlement: I would like the company to reopen my case. I want them to be more professional and communicate with me as to what is going on with my case. They just make decisions without consulting with anyone to see what the status is on their situation. I also want them to send me a breakdown of my individual payments that I never received

Business

Response:

Business Response /* (1000, 5, 2013/07/08) */

Thank you for your inquiry received on June 24, 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 Disability department for assistance with the member's concerns. The disability claim was called in on April 30, 2013. They did not get medical information to support the disability claim until May 16, 2013. The disability claim was approved on May 21, 2013 at which time we called the employee to advise of the approval and what was needed to extend the disability. An approval letter was sent out to the employee. During the approval call, we do not normally discuss the payments unless the employee asks the amounts he will get. With direct deposit an Explanation of Benefit (EOB) is not sent to the employee. Our letters do advise the claim will close and on what date if we do not have updated medical. The employee called upset and had asked for a call back from the benefits manager not understanding why his claim was closed. The benefits manager did call the employee back to walk through when the medical came in and what was received. She did advise it was minimal information. The employee did say he followed up with his doctor's office after he spoke with the customer service representative that morning and the office did share the information it was on doctor's desk and had not been sent over to Aetna and he apologized to the benefits manager as it was not our fault. The Disability department did get updated medical and the member's disability is currently approved to July 16, 2013. Also, Aetna does not issue benefits; they are issued from member's employer.

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: The main issue is, now all of a sudden after covering a medication they refuse to cover it any longer and provide no explanation. I have had aetna insurance since 2010 on this plan and not once have they required a pre certification for my medication. All of a sudden I went to get my script filled and they wouldn't cover it, they said precert was required. So I paid cash. Then they approved the precert for only 3 months, and I was told by their customer service that precertifications are usually good for a year?When my doctor submitted the info to get the precert reissued they denied it.AN appeal was sent to Aetna from my Dr's office and they have not sent any response. Account_Number: wXXXXXXXXX

Desired Settlement: For them to continue the medication that I have been taking for years. My Dr and I have tried other therapies and this dosage works the best for me.

Business

Response:

Business Response /* (1000, 5, 2013/05/17) */

Thank you for your inquiry received on May 3, 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 Pharmacy department for assistance with the member's concerns. An appeal, Case number[redacted].com, was completed and a resolution letter was sent to the member on March 22, 2013. An authorization was backdated, allowing the drug that was filled on November 9, 2012. The authorization is now good for an indefinite timeframe since we have previously approved. The authorization number is XX-XXXXXXXXX, the drug was only approved up until February 26, 2013, however since we have covered this drug before for the member as 4 per day, they have extended it out indefinitely.

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].com.

Consumer Response /* (2110, 7, 2013/05/22) */

(The consumer indicated he/she ACCEPTED the partial settlement response from the business.)

I WOULD LIKE THIS IN WRITING FROM AETNA

Review: I have two pending claims from [redacted] and [redacted] dated 6/11/2014 and Aetna refused to process them. Aetna said that they did not receive the bills on time but the provider did bill the insurance company at the time of the visit.Desired Settlement: Process Claims & Remit Payment to the Hospital & Collection Agency

Business

Response:

Thank you for your rejection notice received on 07/21/15 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: In April 2012, the company I worked for went out of business and my coverage was switched to COBRA. I was covered under COBRA until 8/31/2012. However, Aetna made a clerical error and failed to enter the COBRA information. Because of this, they refused to pay my pharmacy bill of $400. I called & spent an hour on the phone being shuffled around until finally someone took the time to help me and paid the claim. Next, I got a letter saying they paid in error and wanted their money back. I have now spent over 6 months of frustration, including many hours on the phone, trying to resolve this. I've been told by three different people at three different times that the problem was solved. Now, I've received a collections letter.Today, my mom spent 2 hours on the phone with Aetna (we timed it). She, like me, was shuffled around in a circle ending up back where she started. She asked for a supervisor (a Ms [redacted]) three different times and was denied access to her. There seems to be no way to remedy this situation.My credit is now affected by Aetna's error and we have spent hours and hours in extreme frustration trying to fix this problem. What more can we do????

Product_Or_Service: Aetna Insurance

Account_Number: WXXXXXXXXX

Desired Settlement: Fix your error, and clean up my credit. Pay me for the hours I've spent dealing with this. (I know, I'm dreaming).

Business

Response:

Business Response /* (1000, 5, 2013/04/08) */

Thank you for your inquiry received on March 29, 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 Strategic Resource Company (SRC) for assistance with the member's issue. They advised the system was not reflecting the correct termination date for the Cobra coverage as August 31, 2012. They manually corrected the information and Aetna Pharmacy Management (APM) was contacted by SRC to have the credit file number XXXXXXXXXX reviewed. [redacted], Senior Customer Service Representative, with SRC, advised he spoke with the member's mother by phone on April 4, 2013 and explained the situation. We apologize for the delay and inconvenience.

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

Consumer Response /* (2110, 7, 2013/04/16) */

(The consumer indicated he/she ACCEPTED the partial settlement response from the business.)

The only fear we have is that we've been told that this issue has been fixed three different times by three different people (this is the 4th time). We are afraid to hope that this time it really is fixed. We have received no paperwork from Aetna providing us with verifiable proof that this issue is repaired once and for all. For all we know, we will get sent to collections next month as well and we'll start this horribly frustrating phone circle all over again.

Review: I had a surgery done to remove an infection in my body. The insurance company has my claim coded incorrectly as a cosmetic procedure. I contacted them multiple times to resolve the issue. They advised that they did not have the right to contact my Dr. regarding the issue. They wanted 3rd party authorization. After I gave my consent, it took more than 30 days for them to review my dispute of the bill. No follow up calls were made that I requested to keep me updated during the process. I finally called to follow up on the dispute, and was told I was flat out denied. I asked what I would have to pay out of pocket for this so called "cosmetic" procedure to remove an infection from my body. The woman advised that she doesn't know and its up to the hospital to determine what they feel I should pay. This is a poor representation of the company. They do not have my procedure coded correctly. There is another portion of this bill that I am currently paying on. Yet they are cover that bill and not this one as well? They are not consistent with their business practices.Desired Settlement: *I wish that someone would contact my Dr. Directly. Get the correct information. Update my insurance claim. I do not intend to pay the mystery balance that I "might" be getting from the hospital, at any time or date. I will only pay for the procedure that was actually completed. Or I will not pay at at. Contacting me directly is a good start to this resolution, and getting the facts straight.

Business

Response:

Thank you for your inquiry received on 09/08/14 regarding complaint #[redacted] for [redacted]. Our [redacted] Team researched your concerns, and I would like to share the results of the review with you.

Review: A few years ago I purchased Aetna's prescription insurance. About eight months ago I realized that Aetna was charging me a premium of about $40 per month and providing me almost no service. Rarely, when I would need any prescribed medication, some time the medication would not be in the coverage package or the discount was minimal.I decided to cancel the insurance. About eight months ago, with one month's advance notice, I informed Aetna to cancel my prescription insurance. I did not hear back. For last eight months, every month I am receiving the monthly statement every month. The statement shows the balance from the previous month + late penalty fee + the premium for the next month. The latest unpaid total is shown as $361.20. In last eight months I have neither attempted or received any benefit from the insurance.

Product_Or_Service: Aetna Prescription Insurance

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

1. Aetna should stop sending me the statements.2. Cancel the balance of $361.20.3. If any information was sent to the credit rating companies, that information should be corrected so that there is no impact on my credit rating.

Business

Response:

Thank you for your inquiry received on 05/30/2014 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 denied me my [redacted] medicine on 5-29-15.Desired Settlement: I am a [redacted] and need my medicine. I called Aetna and talked to [redacted]. and he denied my coverage.

Business

Response:

Thank you for your inquiry received on 06/01/2015 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: On 1/12/2015 an incorrect claim was submitted by my doctor to aetna resulting in $91.02 being charged to my Aetna [redacted]. I discovered the error and after 10-15 calls to both my doctor and aetna I finally got the claim corrected several months ago. The issue is that even though the claim was corrected the funds were never returned to my Aetna [redacted]. I called Aetna several times to correct and rather than correcting they have made the issue worse by taking an additional $91.02 from my Aetna [redacted]. Now a total of $182.04 is missing from my Aetna [redacted]. Aetna will not correct the issue and responds with "We will put in a request check back in a week" This has been going on for months now and I need Revdex.com's help in getting this issue resolved. I have made several attempts to work with Aetna and it is not working.Desired Settlement: An adjustment resulting in $182.04 being returned to my Aetna HealthFund HRA. $91.02 from the 1/12/2015 original claim that included the error and the additional $91.02 that was taken from my account in Aetna's failed attempt to correct the error.

Business

Response:

Thank you for your inquiry received on 05/05/2015 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.

Check fields!

Write a review of Aetna, Inc.

Satisfaction rating
 
 
 
 
 
Upload here Increase visibility and credibility of your review by
adding a photo
Submit your review

Aetna, Inc. Rating

Overall satisfaction rating

Description: Insurance Companies, Insurance - Accident & Health

Address: 3150 Lenox Park Blvd #110, Memphis, Tennessee, United States, 38115

Phone:

Show more...

Web:

This website was reported to be associated with Aetna, Inc..



Add contact information for Aetna, Inc.

Add new contacts
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | New | Updated