December 17, 2006

 

Comments

i am a single 45 year old female, i was diganosed with bi polar 2007, i am divorced and i have no health insurance where can someone get reseanol insurance.

Posted by: diane at November 16, 2007 7:16 PM

My Doctor said she will not take Aetna Insurance do to problems with the company. I like this doctor and have been seeing her for over a year.

What can I do?

Posted by: Jeff at January 13, 2008 12:09 PM

Your doctor just wants to get paid, and she, unlike others doctors, ethically care for her patient without charging for services they did not perform in order to get enough from the insurance company, who is so crass. I think you should pay for the services yourself, if you can. Maybe the doctor has a sliding fee, for out of pocket paying customers. It should be known that most providers does not want to deal with Aetna, if they can afford not to, because their discounted fees are just minimal. this comes truly at patients' and dentists' expense.

I contacted Aetna about a dentist charging me for services that he did not perform, and was told that they will investigate and get back to me in three weeks. Well, six weeks past and nothing. So I called again, and this time was placed on hold for about 5 minutes. When the representative, Bill, came back on the line, I was told to contact the office myself because Aetna will not do anything, since these charges were reported by a licensed dentist.
No kidding, who else should have reported the charges? An unlicensed dentist?
He said verbatum:
"I mean, what do you expect mam, you're accusing a licensed dentist of fraud, Aetna will not do anything in this case. The claim is already paid"

I pay an insurance premium every month to Aetna, as do millions of people. I went to this dentist, and he does a normal, routine cleaning. and refer both my husband and I to an Orthodontist for braces. Okay, we're grateful to him, and thank him for cleaning our teeth.

We go to the Ortho, and we're told that we both need Scaling, also known as Deep Cleaning. This is the first time, both my husband and I hear of this. After the cleaning, we can get on with braces. He starts treatment before me, and gets his cleaning. The claim is sent to Aetna, and rejected because the previous dentist had already charged for this service.

to be sure that I'm not being unfair, I double checked with the Orthodontics office to see if there are variations of this procedure. No, certain instruments must be used in order to reach the gum where the problem exists. Okay, I then go to wikipedia, my own personal encyclopedia, http://en.wikipedia.org/wiki/Tooth_scaling
Guess what, the service was not perform by the dentist.

I contact Aetna, and of course the rest you know from beginning excerpt.

How does Aetna make its revenue. By charging us exuberant monthly fees, and paying a dentist $288, on a claim of $960. Of course, this does not excuse what this dentist did, but Aetna is mostly to blame because the discount price it pays to dentist for services rendered is pitiful.

Of course my husband has already paid $1800 out of pocket for cleaning that should have been paid by Aetna. Meanwhile, we are out of that $1800, the dentist does not get reprimanded for fraud, & Aetna is laughing all the way to the bank!


Try, Blue Cross Blue Shield, PPO service, they are just super for me and my family, Husband, wife, and two boys.

Posted by: carmelle at June 9, 2008 11:22 AM

It's unfortunate to see so many people being mislead, and frankly, robbed of money, we don't really have. But what are we going to do? I'm in all of your shoes, and can empathise. I have to pay out of pocket to see my psychiatrist, as my mental health and overall well being has greatly improved. However, Screw Cross Screw Shield of Tennessee has this "high deductible" policy, in which they ensure I will never meet the $3,000 deductible. So, $6,000.00 later, I realize I'm paying a premium to pay people at BCBS their salaries. Kind of discouraging, and VERY expensive. I keep the insurance for the event of a catostrophic sickness or injury, but I'm suspect they will find some loop hole to avoid paying a dime.

Then there's Aetna. I had them in the late 90s, and my supposed $200 outpatient co-pay for my shoulder surgery ended up being over $2,000.00 Maybe I missed the double secret zero they used in invisible ink.

Forward 10 years, and I was told Aetna has an individual plan that covers bipolar disorder. Great! So I fill out the app, and then get a rejection letter because I'm bipolar.....Kind of funny.

We spend 19 billion a month on Iraq, but we allow health insurance companies take 19 billion a month out of our pockets, and while they say they are looking out for us, they are not. Too bad the government gets their behinds kissed by effective lobbyists, which keeps the government from trying to break up some of the corporate corruption going on....

Maybe there's a special place in hell for companies that mislead and basically steal from people who are going into debt just so they won't want to blow their head off.

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Posted by: Shaun at October 27, 2008 2:22 AM

I deal with bipolar and received MediCare for 13 years. They dropped me with no notice. And I tried to buy health insurance to cover mental illness in California and I could only find a "high risk plan" that costs $650.00/month! I only receive $870.00/month on disability.

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