Wednesday, April 06, 2016

No Escape From Aetna....

On March 13th, I wrote a post: "To Aetna: I am NOT in Your Network about how I was trying to reach Aetna to clarify that I am not a psychiatrist in their network.  I wanted this clarified because I was getting so many calls from people asking to see me because I am listed on Aetna's website.  I called and called again, but the voicemail prompts left me with no where to go.  When I reached a live person, I was told that Network Services would contact me within 48 hours.  That never happened.  I wrote in through their website.  Nothing.  And finally, I contacted the Maryland Insurance Commission, who contacted Aetna, and  a real live, very helpful person at Aetna did in fact call me.  

So I spoke to the real live person at Aetna who had a name and an direct line phone number.  Why did they think I was in their network?  People have to apply for this, and I had no memory of filling out paperwork.  The real live person, whom I fist spoke with on March 23rd, clarified that I had been an Aetna provider through two clinics where I had once worked.  These are different from my private practice, and participation is based on the billing address.   So I was registered as a provider at an outpatient clinic that I left in 1998, and at another clinic that I left in 2013.  Hmmm, so why did they have me registered at my private office?  Well, apparently last May they received a claim form for out-of-network services and a clerk 'updated' my file, added my address, phone number, tax information, and Voila! I was an involuntary Aetna provider.  No worries, the real live person would fix this and call me.  Only that has not yet happened.  

So the Aetna referrals continue to come, and this continues to take up my time as I call prospective patients back only to explain that I'm not actually in their network.  So I called back the real live person --it's been weeks, and still I'm listed as a participating provider on their website.  How long can it take to remove someone from a website?  Ah, they'll work on it and call me. The days go by, and then the weeks, and Aetna,  I'm waiting......
Update on 4/9: phone call from Aetna saying they had taken me out of their system.  

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