Revdex.com res sent 05/15/@ 05:12pmDear [redacted] ***: Please see our response to complaint # [redacted] for [redacted] that was received by us on May 09, Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with youUpon receipt of the complaint, we contacted Overpayment department to address the member’s concernsWe have confirmed that all pended overpayments have been stoppedWe are no longer pursuing funds from your providers, since the member was active during the date of servicesWe also verified that all claims where money was recouped from the provider’s, have been reprocessed and payments reissuedPlease allow time for payments to be processed and posted by each providerWe take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms [redacted] ’s concernsIf there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, LaShonda C.Complaint and Appeals Consultant Executive Resolution Team
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 our Claims department to have a complete review of the member’s claimsWe were advised that there were four claims on file for 2015, and only one date of service required reprocessingThis claim has been finalized and paid any additional money to the providerAll other claims were processed correctly, and were all processed in network Please accept my apology for the delay in processing your claim correctlyUnfortunately, in some instances, procedural errors do occurWhen 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 Mr***’s concernsIf 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
Complaint: [redacted] I am rejecting this response because: It doesn't provide me with the laminated user Id card that I requested Further, when I wish to change my DMO, the new DMO won't have the information for me on file as described in Aetna's response Additionally I can't even find the Aetna home office phone number off line in my local yellow pages, much less remember it when calling or visiting a new DMO's office I find Aetna's refusal to comply EXTREMELY UPSETTING! If Aetna refuses to have a clerk print, laminate and mail a user id to me, I will at a minimum report this to the State of Colorado Department Of Law Office of the Attorney General I found them to be very helpful in getting [redacted] to comply with a recent consumer complaint I filed Sincerely, [redacted]
HelloThank 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 youUpon receipt of the complaint, we contacted our Customer Service department to review the member’s concernsWe listened to the phone call dated February 01, and confirmed that the member was quoted benefits that the diagnostic tests would be allowed at 100% after the $deductible was metThe customer service associate explained that the member’s deductible had not been metThe associate did not educate the member on some of the procedure codes would be subject to medical review based on the member’s conditionWe have provided feedback to the associate that handled the callWe also contacted our Claims department and verified that the member’s claim was processed according to the plan benefitsThe procedure [redacted] was allowed and applied $toward the deductibleThe procedure [redacted] and [redacted] were denied because they are considered experimentalThe member's level one appeal denied on May 18, If the member disagrees with this decision, she may request a second level appealWe can assist the member with the appeal submissionWe attempted to reach the member on May 27, and left a messageWe will make another attempt on Tuesday, May 31, The member can also contact me directly at ###-###-####.We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [email protected] Thank you, LaShonda C.Complaint and Appeal Consultant Executive Resolution Team
Dear Ms [redacted] ***: Please see our response to complaint # [redacted] for [redacted] that was received by us on December 20, 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 our Precertification department to have the member’s concerns reviewedWe requested that the Precertification department review the member’s request as soon as possible due to the delay the member was experiencing surrounding the requestWe were advised that on Thursday December 22, 2016, our Precertification department spoke with the provider’s office and confirmed that the codes that were being requested did not require a precertification request and apologized that the request was not handled sooner The provider confirmed the member was aware she was using her out-of-network benefits and again apologized for the inconvenience the office and the member experiencedWe have provided additional training and feedback to those involved in the handling of this requestThe provider will contact the member to set up having the services rendered 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 there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, Ashley WComplaint and Appeals Consultant Executive Resolution Team
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 our Benefit’s department to review the coordination of benefits (COB) information on fileIt was verified that based on COB guidelines, the determination of the mother’s plan being primary was correctAfter receiving confirmation that the daughter is now residing with the father, we consulted with our Legal department to ensure there would not be any issues with making the plan primary based on the information provided Given the living arrangements for the daughter we have made the COB change based on this updated informationThe COB has been updated to show the father’s plan as primary for the daughter effective March 01, We spoke directly with the member yesterday March 15, 2016, to explain in detail our findings and he was accepting of our resolution We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf 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
Hello, Thank you for your inquiry, regarding complaint [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 our Eligibility department to have the member’s concerns reviewedWe confirmed that they reached out to the member’s university and the department was advised that the member submitted a waiver on December 31, 2015, but it was rejected as they were unable to verify – “Policy no longer active” – on this date the policy was not active as it was not effective until January 01, On January 08, 2015, the member contacted the university was able to verify the coverage and process the refund The university bills the student’s the insurance premium, the students do not pay Aetna directlyPer the university, they have processed the refund for the student the amount of the Spring insurance premium of $2, We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf 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
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 your inquiry, we contacted our Billing department regarding this member's complaintWe have confirmed that the employer, specifically The Office of Personnel Management, changes the premiums each year on their websiteFor 2015, general information was released on 9/29/and can be found at the link: [redacted] The premiums are also notated in every plan brochure, available on lineThe federal government has a “Green Initiative”, and does not distribute brochuresThe eligibility I currently show continues to be enrollment code JSfor single coverage [redacted] which indicates the member should still be paying the $ premiumWe cannot change the member’s plan or refund any monies paid toward her premiumUltimately, she must resolve her intent with her payroll department as stated previouslyWe take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms [redacted] ’s concernsIf you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Thank you, LaShonda C Complaint and Appeal Consultant Executive Resolution Team
Dear [redacted] *** Please see our response to complaint # [redacted] for [redacted] that was received by us on November 30, Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you Upon receipt of the member’s complaint we reached out to our Consumer Business department to have the member’s concerns reviewedBased on review of the bill the member received, we confirmed it was generated in errorThe $was written off and the member is currently showing a $balance I apologize for the frustration this situation has caused the memberAetna’s goal is to provide prompt, accurate responses to inquiries from our constituents We regret that this matter required additional follow up from the member in order to facilitate resolution This is not indicative of Aetna’s standards and we appreciate the member’s patience during the time involved in researching and resolving his issue 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 there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, Kim BComplaint and Appeals Consultant Executive Resolution Team
Hello, Thank you for your inquiry, regarding complaint #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 Accounting department to have the member’s concerns reviewedWe were advised by [redacted] that the claim needs to be submitted to [redacted] as they were given all the financial details and [redacted] will pay the claim The member did submit a claim that was received on December 31, 2015, but the claim was not processed until January 06, Per [redacted] will handle all Run Off and Grace Period processingNo further processing by will be completed by Aetna as of January 01, We sent the request back to the member on January 06, and advised the member to resubmit to [redacted] since they are responsible for handling the Run Off and Grace PeriodPlease have the member send the information directly to [redacted] with their new account informationWe apologize for any inconvenience this may have caused the member We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] s concernsIf 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
Dear [redacted] ***: Please see our response to complaint # [redacted] for [redacted] that was received by us on May 29, Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you Upon receipt of the member’s concerns, we immediately reached out to a representativeThey researched this issue and have provided a responseThe member’s wife said that her husband had [redacted] surgery on May 18, She said he was released from the hospital to an inpatient rehabilitation center and taken to one that was not the location that was agreed to After review, it seems we received this notification after the issue was resolvedWe originally approved for the requested location of [redacted] ***, and we never changed the admission to [redacted] ***It appears there was a misunderstanding in the transfer from the hospitalThe member has resolved the issue by checking themselves out of the incorrect location and readmitting to the correct oneAetna has no record of a denial 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 there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, Michael H SrComplaint and Appeal Analyst Executive Resolution Team
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Sincerely, [redacted] ***
Hello, Thank you for your inquiry, regarding complaint # [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 our Eligibility department and requested the policy be terminated per the member’s request as of December 31, Our records indicate that the policy reflects terminated as of December 31, 2015, and we have also approved the premium refundPlease allow 2-business days for the $refund to be electronic deposited in the member’s bank account Please accept my apology that we did not provide the level of service that you rightfully expect and deserve, and my assurance that your concerns are getting the highest level of attention at AetnaI would also like to thank you for sharing your experience with usIt is feedback like yours that helps us address issues and prevent them from reoccurring We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf 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
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me Sincerely, [redacted]
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 I sincerely apologize that we originally reviewed the first request incorrectlyOur executive team will make an exception if the member wishes and reopen the open and waive the timely filing so we can have the services reviewed based upon wrong information givenWe already have the request in writing from the first appeal request, which is required by the employer, so if the member wishes to pursue this exception please have her send an email to my attention to the email address below and we will start an appeal immediately 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 concernsIf 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
Complaint: [redacted] I should get a full refund It's obvious your online billing system is filled with glitches It's not my fault that your system was unable to process my request It is downright criminal that you would erroneously bill me with your inefficient system and have the audacity to refuse to give me a refund Sincerely, [redacted]
Hello, Thank you for your inquiry, regarding complaint [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 our Enrollment and Eligibility department to have the member’s concerns addressedWe were advised that this member changed plan options in The member changed from the CDHP plan, enrollment code EP1, to the Aetna Direct plan, enrollment code [redacted] The FEHBP brochure states in section 5: “If you terminate your participation in this Plan, any remaining Medical Fund balance will be forfeited.” If the member would have stayed in the same plan, the funds would rollover from year to year, but due to the plan change the member forfeited the funds in the account We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address MrFreedman’s concernsIf 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
Complaint: [redacted] I am rejecting this response. This has happened again just today. Aetna rejected my claim from the same provider siting the reason of "no diagnosis code" on the claim. The diagnosis code is clearly provided on the claim. They do this every time! I can provide documents and claim numbers as I have copies of the submitted claim. Sincerely, [redacted] ***
Thank you for your inquiry received on [redacted] 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 the Flexible Spending Account (FSA) department, and the member’s check for $has been reissued as of [redacted] We apologize for any inconvenience this may have caused 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]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Sincerely, [redacted] I have sent an email to Aetna as suggestedI'm hoping this can be resolved without further detriment to my creditThank you for your assistance in this matter
Revdex.com res sent 05/15/@ 05:12pmDear [redacted] ***: Please see our response to complaint # [redacted] for [redacted] that was received by us on May 09, Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with youUpon receipt of the complaint, we contacted Overpayment department to address the member’s concernsWe have confirmed that all pended overpayments have been stoppedWe are no longer pursuing funds from your providers, since the member was active during the date of servicesWe also verified that all claims where money was recouped from the provider’s, have been reprocessed and payments reissuedPlease allow time for payments to be processed and posted by each providerWe take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms [redacted] ’s concernsIf there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, LaShonda C.Complaint and Appeals Consultant Executive Resolution Team
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 our Claims department to have a complete review of the member’s claimsWe were advised that there were four claims on file for 2015, and only one date of service required reprocessingThis claim has been finalized and paid any additional money to the providerAll other claims were processed correctly, and were all processed in network Please accept my apology for the delay in processing your claim correctlyUnfortunately, in some instances, procedural errors do occurWhen 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 Mr***’s concernsIf 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
Complaint: [redacted] I am rejecting this response because: It doesn't provide me with the laminated user Id card that I requested Further, when I wish to change my DMO, the new DMO won't have the information for me on file as described in Aetna's response Additionally I can't even find the Aetna home office phone number off line in my local yellow pages, much less remember it when calling or visiting a new DMO's office I find Aetna's refusal to comply EXTREMELY UPSETTING! If Aetna refuses to have a clerk print, laminate and mail a user id to me, I will at a minimum report this to the State of Colorado Department Of Law Office of the Attorney General I found them to be very helpful in getting [redacted] to comply with a recent consumer complaint I filed Sincerely, [redacted]
HelloThank 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 youUpon receipt of the complaint, we contacted our Customer Service department to review the member’s concernsWe listened to the phone call dated February 01, and confirmed that the member was quoted benefits that the diagnostic tests would be allowed at 100% after the $deductible was metThe customer service associate explained that the member’s deductible had not been metThe associate did not educate the member on some of the procedure codes would be subject to medical review based on the member’s conditionWe have provided feedback to the associate that handled the callWe also contacted our Claims department and verified that the member’s claim was processed according to the plan benefitsThe procedure [redacted] was allowed and applied $toward the deductibleThe procedure [redacted] and [redacted] were denied because they are considered experimentalThe member's level one appeal denied on May 18, If the member disagrees with this decision, she may request a second level appealWe can assist the member with the appeal submissionWe attempted to reach the member on May 27, and left a messageWe will make another attempt on Tuesday, May 31, The member can also contact me directly at ###-###-####.We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [email protected] Thank you, LaShonda C.Complaint and Appeal Consultant Executive Resolution Team
Dear Ms [redacted] ***: Please see our response to complaint # [redacted] for [redacted] that was received by us on December 20, 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 our Precertification department to have the member’s concerns reviewedWe requested that the Precertification department review the member’s request as soon as possible due to the delay the member was experiencing surrounding the requestWe were advised that on Thursday December 22, 2016, our Precertification department spoke with the provider’s office and confirmed that the codes that were being requested did not require a precertification request and apologized that the request was not handled sooner The provider confirmed the member was aware she was using her out-of-network benefits and again apologized for the inconvenience the office and the member experiencedWe have provided additional training and feedback to those involved in the handling of this requestThe provider will contact the member to set up having the services rendered 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 there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, Ashley WComplaint and Appeals Consultant Executive Resolution Team
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 our Benefit’s department to review the coordination of benefits (COB) information on fileIt was verified that based on COB guidelines, the determination of the mother’s plan being primary was correctAfter receiving confirmation that the daughter is now residing with the father, we consulted with our Legal department to ensure there would not be any issues with making the plan primary based on the information provided Given the living arrangements for the daughter we have made the COB change based on this updated informationThe COB has been updated to show the father’s plan as primary for the daughter effective March 01, We spoke directly with the member yesterday March 15, 2016, to explain in detail our findings and he was accepting of our resolution We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf 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
Hello, Thank you for your inquiry, regarding complaint [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 our Eligibility department to have the member’s concerns reviewedWe confirmed that they reached out to the member’s university and the department was advised that the member submitted a waiver on December 31, 2015, but it was rejected as they were unable to verify – “Policy no longer active” – on this date the policy was not active as it was not effective until January 01, On January 08, 2015, the member contacted the university was able to verify the coverage and process the refund The university bills the student’s the insurance premium, the students do not pay Aetna directlyPer the university, they have processed the refund for the student the amount of the Spring insurance premium of $2, We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf 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
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 your inquiry, we contacted our Billing department regarding this member's complaintWe have confirmed that the employer, specifically The Office of Personnel Management, changes the premiums each year on their websiteFor 2015, general information was released on 9/29/and can be found at the link: [redacted] The premiums are also notated in every plan brochure, available on lineThe federal government has a “Green Initiative”, and does not distribute brochuresThe eligibility I currently show continues to be enrollment code JSfor single coverage [redacted] which indicates the member should still be paying the $ premiumWe cannot change the member’s plan or refund any monies paid toward her premiumUltimately, she must resolve her intent with her payroll department as stated previouslyWe take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms [redacted] ’s concernsIf you have any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Thank you, LaShonda C Complaint and Appeal Consultant Executive Resolution Team
Dear [redacted] *** Please see our response to complaint # [redacted] for [redacted] that was received by us on November 30, Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you Upon receipt of the member’s complaint we reached out to our Consumer Business department to have the member’s concerns reviewedBased on review of the bill the member received, we confirmed it was generated in errorThe $was written off and the member is currently showing a $balance I apologize for the frustration this situation has caused the memberAetna’s goal is to provide prompt, accurate responses to inquiries from our constituents We regret that this matter required additional follow up from the member in order to facilitate resolution This is not indicative of Aetna’s standards and we appreciate the member’s patience during the time involved in researching and resolving his issue 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 there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, Kim BComplaint and Appeals Consultant Executive Resolution Team
Hello, Thank you for your inquiry, regarding complaint #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 Accounting department to have the member’s concerns reviewedWe were advised by [redacted] that the claim needs to be submitted to [redacted] as they were given all the financial details and [redacted] will pay the claim The member did submit a claim that was received on December 31, 2015, but the claim was not processed until January 06, Per [redacted] will handle all Run Off and Grace Period processingNo further processing by will be completed by Aetna as of January 01, We sent the request back to the member on January 06, and advised the member to resubmit to [redacted] since they are responsible for handling the Run Off and Grace PeriodPlease have the member send the information directly to [redacted] with their new account informationWe apologize for any inconvenience this may have caused the member We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] s concernsIf 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
Dear [redacted] ***: Please see our response to complaint # [redacted] for [redacted] that was received by us on May 29, Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you Upon receipt of the member’s concerns, we immediately reached out to a representativeThey researched this issue and have provided a responseThe member’s wife said that her husband had [redacted] surgery on May 18, She said he was released from the hospital to an inpatient rehabilitation center and taken to one that was not the location that was agreed to After review, it seems we received this notification after the issue was resolvedWe originally approved for the requested location of [redacted] ***, and we never changed the admission to [redacted] ***It appears there was a misunderstanding in the transfer from the hospitalThe member has resolved the issue by checking themselves out of the incorrect location and readmitting to the correct oneAetna has no record of a denial 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 there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at [redacted] Sincerely, Michael H SrComplaint and Appeal Analyst Executive Resolution Team
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Sincerely, [redacted] ***
Hello, Thank you for your inquiry, regarding complaint # [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 our Eligibility department and requested the policy be terminated per the member’s request as of December 31, Our records indicate that the policy reflects terminated as of December 31, 2015, and we have also approved the premium refundPlease allow 2-business days for the $refund to be electronic deposited in the member’s bank account Please accept my apology that we did not provide the level of service that you rightfully expect and deserve, and my assurance that your concerns are getting the highest level of attention at AetnaI would also like to thank you for sharing your experience with usIt is feedback like yours that helps us address issues and prevent them from reoccurring We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address [redacted] concernsIf 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
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me Sincerely, [redacted]
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 I sincerely apologize that we originally reviewed the first request incorrectlyOur executive team will make an exception if the member wishes and reopen the open and waive the timely filing so we can have the services reviewed based upon wrong information givenWe already have the request in writing from the first appeal request, which is required by the employer, so if the member wishes to pursue this exception please have her send an email to my attention to the email address below and we will start an appeal immediately 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 concernsIf 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
Complaint: [redacted] I should get a full refund It's obvious your online billing system is filled with glitches It's not my fault that your system was unable to process my request It is downright criminal that you would erroneously bill me with your inefficient system and have the audacity to refuse to give me a refund Sincerely, [redacted]
Hello, Thank you for your inquiry, regarding complaint [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 our Enrollment and Eligibility department to have the member’s concerns addressedWe were advised that this member changed plan options in The member changed from the CDHP plan, enrollment code EP1, to the Aetna Direct plan, enrollment code [redacted] The FEHBP brochure states in section 5: “If you terminate your participation in this Plan, any remaining Medical Fund balance will be forfeited.” If the member would have stayed in the same plan, the funds would rollover from year to year, but due to the plan change the member forfeited the funds in the account We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address MrFreedman’s concernsIf 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
Complaint: [redacted] I am rejecting this response. This has happened again just today. Aetna rejected my claim from the same provider siting the reason of "no diagnosis code" on the claim. The diagnosis code is clearly provided on the claim. They do this every time! I can provide documents and claim numbers as I have copies of the submitted claim. Sincerely, [redacted] ***
Thank you for your inquiry received on [redacted] 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 the Flexible Spending Account (FSA) department, and the member’s check for $has been reissued as of [redacted] We apologize for any inconvenience this may have caused 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]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Sincerely, [redacted] I have sent an email to Aetna as suggestedI'm hoping this can be resolved without further detriment to my creditThank you for your assistance in this matter