I had an appt in June with an in-network doctor using Telehealth. I initially noticed that the Telehealth fee was denied by insurance (Aetna). I called and inquired about it. They assured me I will not owe anything. They then did a 3 way call with me, Aetna, and the doctors office. It sounded like the problem was it was not submitted as “Incidental”. So it was submitted again correctly, and Aetna still denied the claim. Now I have an outstanding balance on my account at the doctors clinic for this Telehealth fee. I have not received a bill in the mail yet though.
I called Aetna again, and they again assured me that I will not be responsible for this fee, and that it clearly states in the EOB that was sent to the clinic that I am not responsible for it. So I called the clinic and told them to check the EOB, and they said the problem is due to a coding problem from Aetna and that Aetna needs to fix it, otherwise I am going to be receiving the actual bill in a few weeks. And that the clinic cant just write off the fee (so it sounds like Aetna needs to pay for it?). Apparently the clinic has told Aetna about this coding issue back in August and nothing has still been done about it.
So I called Aetna back again and told them this. I didnt understand what that person all said, she did a lot of explaining but she was very hard to understand, but assured me again I will not be responsible for this fee. She made it sound like the provider and Aetna still need to hash things out. I’m just really confused. What can I do? I am so sick of going back and forth between insurance and clinic
submitted by /u/pizzunk
[link] [comments]I had an appt in June with an in-network doctor using Telehealth. I initially noticed that the Telehealth fee was denied by insurance (Aetna). I called and inquired about it. They assured me I will not owe anything. They then did a 3 way call with me, Aetna, and the doctors office. It sounded like the problem was it was not submitted as “Incidental”. So it was submitted again correctly, and Aetna still denied the claim. Now I have an outstanding balance on my account at the doctors clinic for this Telehealth fee. I have not received a bill in the mail yet though. I called Aetna again, and they again assured me that I will not be responsible for this fee, and that it clearly states in the EOB that was sent to the clinic that I am not responsible for it. So I called the clinic and told them to check the EOB, and they said the problem is due to a coding problem from Aetna and that Aetna needs to fix it, otherwise I am going to be receiving the actual bill in a few weeks. And that the clinic cant just write off the fee (so it sounds like Aetna needs to pay for it?). Apparently the clinic has told Aetna about this coding issue back in August and nothing has still been done about it. So I called Aetna back again and told them this. I didnt understand what that person all said, she did a lot of explaining but she was very hard to understand, but assured me again I will not be responsible for this fee. She made it sound like the provider and Aetna still need to hash things out. I’m just really confused. What can I do? I am so sick of going back and forth between insurance and clinic submitted by /u/pizzunk [link] [comments]Read Morer/HealthInsurance