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Report: #1257148

Complaint Review: Aetna - Nationwide

  • Submitted:
  • Updated:
  • Reported By: Jay and Corine Root — Austin Texas USA
  • Aetna Nationwide USA

Aetna (also complaining against MinutemanClinic of Texas) They Can Record You But You Can't Record Them Lexington, KY Nationwide

*Author of original report: Aetna Records You But You Can't Record Them

*General Comment: Sometimes.

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How do you get information to appeal the denial of a health insurance claim?

If you read the letters they send you, they're required to give you "evidence" they've collected so you can fight your denial. And wouldn't audio recordings be considered evidence?

First, allow me to quote from the letter Aetna sent us when they denied a claim in July, for services rendered in May. It's under the headline "Access to relevant information."

"At your request, we will give you free of charge access to copies of all documents, records and other information about your claim for benefits, including the specific rule, guideline, protocol, or other similar criterion that was used in making the decision ..."

So we were told repeatedly -- in phone calls recorded by Aetna -- that a meningitis vaccination at MinuteManClinic of Texas would be covered. We were a little wary, because sometimes they say it's covered and it's not, so we really made sure. We called both the clinic and we called Aetna and of course we presented the insurance card at the clinic on the date of service and they all said it was covered.

Except it wasn't.

They want their money now, and I want the tapes. I want the audio files because it will show beyond a shadow of a doubt that they told us repeatedly it was covered. Now I'm getting collection notices from MinuteManClinic -- I knew this would happen -- while the "second level appeal" is ongoing. What does Aetna say about that? Sorry, bro. Pay it.

Meanwhile, not only will Aetna not give me the audio files -- the "evidence" I need to fight my denial -- they say that we can't record their phone calls even though they can record ours.

Outrageous.

 

This report was posted on Ripoff Report on 09/25/2015 12:02 PM and is a permanent record located here: https://www.ripoffreport.com/reports/aetna/nationwide/aetna-also-complaining-against-minutemanclinic-of-texas-they-can-record-you-but-you-can-1257148. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
1Author
1Consumer
0Employee/Owner

#2 Author of original report

Aetna Records You But You Can't Record Them

AUTHOR: - ()

POSTED: Friday, September 25, 2015

Actually, no, they never allege something was covered and then suddenly was no longer covered, but nice try.

They acknowledge that the service was NEVER covered under our plan. 

They also acknowledged in one call, after the denial, that their own representatives told us that it was covered.

They don't dispute that Minuteman told it was covered.

They don't dispute that Minuteman took our insurance card and didn't charge us at the time of service. 

They led us astray, but we have to pay anyway ... or so they say. I've already spent way more time and effort than what it's worth, but I refuse to be taken advantage of. It's plain wrong and I want people to know about it.

They've already turned me over to bill collectors, despite the ongoing nature of the dispute.

Yet they still refuse to hand over the audio files demonstrating beyond a shadow of a doubt that they directed us to Minuteman and told us it was covered.

And yes, Aetna told me they can record us, but we can't record them.

If you think that's fair, I'd like to know on what basis.

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#1 General Comment

Sometimes.

AUTHOR: Tyg - (USA)

POSTED: Friday, September 25, 2015

 As with ANY insurance things change. At the time of the call it could have been covered, but by the time you went in it had changed to NOT covered. THAT doesnt make it a ripoff. Just because you have to PAY for something that USED to be covered doesnt make it a ripoff. Things change and its YOUR mark as an adult as to HOW you handle it.

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