On Feb 4, 2009 I made an emergency trip to the Mayo Clinic (closest hospital to my home)in the middle of the night. I was diagnosed as having A-fib. After trying several medications, they finally determined that they would have to stop my heart and re-start it in hopes that they could restore a normal beat.
All paperwork was filed with AETNA at the time, reviewed, questions answered and the claim was paid. (Note, Mayo clinic was an "out of network" provider, but in an emergency it was determined that this was allowable.)
In January 2011 (two years after the event), Aetna decided to reverse the payment made. They charged the payment back to Mayo, who is now charging me for the services.
I have talked with 4 different people at AETNA and all have told me that since it was an emergency, it definitely should be covered and they will process the paperwork to do so. They have told me that they will contact the hospital also.
After 2 1/2 months, I find that nothing has happened. They still have not processed this through. They don't return calls, or follow up on promises made.
The last call I made to them: they felt they overpaid the bill. Apparently, paying less than 1/3 of the bill is too much...even though I had a plan that should have covered everything over $5000-- that definitely didn't happen. Since I only have a certain number of days in which to make a claim....why is it that after TWO YEARS they can still pull back payments made and now claim that they made an error and overpaid this claim?
Read Next Complaint >>
