Aetna is a healthcare company that offers insurance plans and related services.
In 1953 Aetna Life Insurance was founded in Connecticut.
In 1891 the company diversified into accident insurance and in 1899 to health insurance.
In 1960 Aetna expanded internationally when it opened an office in Toronto, Canada.
In 1968 the company went public, trading publicly on the New York Stock Exchange under the symbol AET.
Today Aetna, Inc. operates in three segments: Health Care, Group Insurance, and Large Case Pensions.
The company’s customers include employer groups, individuals, part and full-time workers, health care providers, government-sponsored plans, labor groups, governmental units, and expatriates.
Aetna is a member of the S&P 500, is #84 on the Fortune 500, has almost 50,000 employees, and had $60.6 billion in revenue in 2020.
In September 2021, Aetna sued NYC and a rival health insurers group over a $34 billion Medicare contract it says was awarded to unqualified bidders.
Also in September 2021, Aetna was hit with a class action lawsuit alleging that the company had discrimanatory practices for those seeking mental health services.
Aetna maintains a corporate office in Harford, Connecticut.
Aetna is a healthcare company that offers insurance plans and related services.
In 1953 Aetna Life Insurance was founded in Connecticut.
History
In 1891 the company diversified into accident insurance and in 1899 to health insurance.
In 1960 Aetna expanded internationally when it opened an office in Toronto, Canada.
In 1968 the company went public, trading publicly on the New York Stock Exchange under the symbol AET.
Today Aetna, Inc. operates in three segments: Health Care, Group Insurance, and Large Case Pensions.
The company’s customers include employer groups, individuals, part and full-time workers, health care providers, government-sponsored plans, labor groups, governmental units, and expatriates.
Aetna is a member of the S&P 500, is #84 on the Fortune 500, has almost 50,000 employees, and had $60.6 billion in revenue in 2020.
In September 2021, Aetna sued NYC and a rival health insurers group over a $34 billion Medicare contract it says was awarded to unqualified bidders.
Also in September 2021, Aetna was hit with a class action lawsuit alleging that the company had discrimanatory practices for those seeking mental health services.
Aetna maintains a corporate office in Harford, Connecticut.
If you have MS they will NOT cover your medicine unless it’s a 25-year-old injectable. But they will tell you “good news we will cover a wheelchair”. Yes, that is the quote I have gotten from not or 2 people there but numerous. It’s a disgrace that they call this a health care provider
I was forced to change over from Coventry to Aetna Medicare this year. Evidently Aetna absorbed Coventry. So far I’m not impressed. I think I made a big mistake sticking with Aetna. I tried to call their designate for hearing aids, Hearing Care solutions to make an appointment. After calling several times and waiting a painfully long wait time I finally spoke with an agent from HSC. The agent couldn’t find or contact a provider in my area to make an appointment. After several other options for providers I agreed to a call back. Still waiting. I called Aetna to see if I could use another provider. Both times was told wait time to speak with an Aetna agent would be 30 minutes. Hung up on the first time. Still waiting on hold on my second attempt. I’ve never experienced such horrible customer service in my life. I’ll probably have to suffer through this year with Aetna but you can bet I’ll go elsewhere next year
Joke of a company…Management is bad, and customer service is worse.
Case ID# 2019010902036
We’re sorry
Error occured while loading the component, please try again soon.
Please call the toll free number on your Id Card for help or Contact Us
Error Code: [7009]
Still not working. I need medicine. I will not call due to you spending over 20 minutes on phone to get my secondary insurance setup with you. All you did was transfer her from incompetent person to another. It still is not taken care of.
Seeing you don’t care. I will start getting local, state, board of medicine, etc. involved.
My God
What did I do??? Listening to my Doctors, I chose Aetna
do any of them know the he’ll you go through trying to get a human being in the line. Now that it’s to late to switch providers, I pray that “God’ keeps me Healthy” throughout the year, so that I will not have to deal with this aggravation. Make it clear, I have and continue to apologize to the young ladies Tacasia & Yolanda who were finally able to assist me, because I started the conversation full of frustration and anger, yet they remained so respectful and kind, which helped to calm down my anxiety.
Case ID# 2019010902036
We’re sorry
Error occured while loading the component, please try again soon.
Please call the toll free number on your Id Card for help or Contact Us
Error Code: [7009]
Still not working. I need medicine. I will not call due to you spending over 20 minutes on phone to get my secondary insurance setup with you. All you did was transfer her from incompetent person to another. It still is not taken care of.
Seeing you don’t care. I will
To:
Mark Bertolini
Karen Lynch
Richard di Benedetto
Shawn Guertin
Rick Jelinek
Steven Kelmar
Meg McCarthy
Harold L Paz
My name is Jeannie Shaffer and I am writing to you in regatrds to my husband and the injustice that we are going through. My husband wa diagnosed with Hidradenitis Suppurativa in November 2016. For him this is an extremely dibilitating disease. Most people have never heard of it, including us. We were on long term disability through Aetna until November 2017, at which time they informed us they were stopping benefits because they state they did not receive a piece of paper feom a doctor, which by the way I watched as they faxed it to Aetna. Since then we have had to sell everything we own just to make our rent and bills. Before this disease my husband was outgoing, loving life, ran multiple businesses, was a great and dun person to be around. Since the disease he has developed depression, severe anxiety and agoraphobia. He has extreme chronic pain, is now in a wheelchair and it takes everything I have to get him to leave the house. He has a PIC line in his arm, goes to doctors on almost a daily basis, has been to the hospital a couple of times and Aetna has still not turned his disability back on. We are now facing eviction and there is no help in sight. Aetna has ruined my family, our lives and has taken the only source of income away. When I speak to their customer service, because you cannot call anyone directly, I am told that it is not their problem and we will be notified if the appeal is approved or not. We have been upstanding citizens and are now reduced to sitting on street corners begging for money so we can pay our bills. No one seems to care or want to help. We are in dire straits, again because of Aetna, not of something of our own doing. Thank you for reading this and hopefully it matters. Aetna tells us that they have 24 hours to return calls, then why do I have to wait days if ever for a return call. Case managers or claims managers are extremely rude, make you feel as though you are nothing and they are better than you are. I certainly hope that no one at Aetna ever has to use the LTD, especially if they have it through Aetna. My husband is disabled and cannot work. I cannot work as I have to be home with him. He falls all the time, cannot sit for very long and when he does go to get up must have help. We do not understand why this company is doing this to us. Nor do we understand why this company has employees that are allowed to treat people the way they do. Not explaining things, not being clear and concise unless it is something beneficial to Aetna. Aetna goes against their own values and beliefs, if you can believe what is on their website.
Sincerely,
Jeannie Shaffer
In addition,I see some.comments referring to billing. Aetna has multiple billing systems reps must use. Oracle FIS ASD and then billing in RUMBA. None of these systems are in line with each other. Only a few reps know how to use all 4 systems and most don’t.
Refunds and reimbursements-average turn around time is 7-10 days for 2nd and 3rd requests however with refunds members submit doXXXXents and they go to ECHS or SECURE ARCHIVES or IOP they are never entered in one place for retrieval with hampers disbursement. Generally turn around time is 4-6weeks. If the doXXXXent is not processed but it’s received and over the 4-6 weeks then it’s another 4-6 weeks. Totally unfair to the member.
There is no checks to ensure reps are actually putting in requests because there is no doXXXXentation of actions taken just point and click no detail.
All calls are recorded but not monitored all the time.
Wrong information is often placed on I’d cards and member materials as well as given to the member via doc find or EPDB. Again no checks to ensure correct information is given. Unfair to members.
As a former employee I brought this to AETNAS attention but they did nothing except fire me and I was one of the best reps there who went above and beyond. Go figure
Good morning.
I am a former employee of Aetna and I would like to take the time to advise you of some things that have occurred during my time there at the BLUE BELL office which I found disturbing.
First,I would like to start by saying I appreciated the opportunity to work for Aetna so I thank you for that.
My position at Aetna was as a customer service representative for Part C. During my time there I learned and trained on your values and commitments such as FCR,First Call Resolution, Accountability and QUEST.
On just about every call members were extremely satisfied with my service and that I was an advocate for them on many issues such as providers balance billing,and incorrect claims processing etc.
In or around August 2017 there were about 15 employees that were let go for call avoidance,yet the supervisors and managers remained. I found this to be alarming because everyday there are “short cuts” given unofficially to representatives as a means to adhere to their SCAD. This brings me to the SCAD issue.
As a rep,the tools used to measure SCAD are flawed. Verint and another program(the name escapes me) used to gauge calls taken and aux use are not always updated not available. This makes reps appear to be below average when in fact they are not.
I mentioned short cuts pertaining to SCAD,allow me to explain.
Integrity and honesty are other key qualities of Aetna that is impressed upon representatives. With that being said,the supervisors there do not always adhere to it. There is a favouritism standard applied.
For example, reps are routinely told to use exceptions or SMT’s for just about anything. Talking with co workers,going to the cafeteria,talking on cell phones etc.Aetna has a cell phone policy but at any given time supervisors are at their desks texting on their cell phones while at the same time enforcing a rule they don’t follow on reps.
I do not see this as honest when reps are told to put SYSD(SYSTEM DOWN) for ANY and everything . To me that constitutes call avoidance when reps are allowed to use exceptions to carry on non work related conversations with supervisors and other reps.
Depending on how your supervisor feels about you will determine if your exceptions are actually applied or not.
Which brings me to the actual calculations of SCAD.
Recognition of exceptional customer service was another thing based on favouritism. In.my case I had to fight to be recognized while.other reps record daily emails on service provided. My supervisor would not want to take calls where a member requested to speak to them to give a recommendation and show appreciation for my service. Instead the supervisor woukd insist I out them into the IVR even though on a recorded line the member is requesting a supervisor.
To be reprimanded for doing your job even if it takes you over scheduled times and then to have to fight for proper recognition is definitely a moral killer. But such is my experience at Aetna.
After the 15 reps were terminated,PART C at Blue bell began doing daily time audits. It was during this time the use of exceptions was pushed hard. However supervisors had access to them and can alter them or not put them through. This practice would make a rep who is always at his or her desk on calls appear to not be meeting schedule adhearance. I find that to be an unfair and dishonest practice at the BLUE bell office.
Other departments like Part d do not have such metrics or practices which I believe accounts for why their turn over rate is so low.
I have witnessed reps abuse their benefits such as claiming a mental issue to remain on payroll while they travel. I have also witnessed reps literally cursing members out while supervisors who are within earshot say and do nothing.
I have witnessed fights on the floor amongst reps and supervisors nor managers do anything.
One such incident occurred around the same time where these reps were fighting each other in training and once on the floor it continued.
The only time management got involved was when one of the three employees was physically confronted by another during work hours, yet this was an ongoing issue and management remained silent.
One employee was fired and the other who was confronted was required to file a police report. The third employee had already quit by then but was a participant in the confrontation via text messaging during work hours.
I have witnessed reps openly groping each other (Females) and management nor supervisors did anything.
In my case, I stayed at my desk performing my job but these were constant distractions that were not handled by management.
As far as my SCAD,each supervisor there would see that I am on a call and knew why I would miss a scheduled break or lunch and allow me to take it later only to be penalized via my SCAD reports later.
Because I believe in honesty and integrity I did not submit fraudulent exceptions as instructed by my supervisor in part because I am an honest employee and I saw what happened to the previous 15 reps who were let go for following the leads of supervisors and seasoned employees.
This is the work environment that I and other reps who come to.work to do their jobs are subjected to.
Although I was given a glowing letter of recommendation by my supervisor prior to my termination for SCAD I believe that I am being black balled or given bad reviews when prospective employers call.
I have no solid proof of this but I will say that of the 4 jobs applied to which I submitted the letter of recommendation for some reason I was not selected where as other positions I did not submit the letter to I was selected but unfortunately the salary was not what I was seeking.
Another disturbing occurance was the fact that to avoid termination I applied for two positions in another department. I was actually sought out by another supervisor for one position. I interviewed and was offered the position pending approval by my manager.
On both occasions I was told my transition which would have continued my employment and put me into a more professional work environment was denied. The reason given was because open enrollment was upon us. I took issue with this because I noticed that 3 Female customer service reps were allowed to transition right before and during open enrollment.
To me this would constitute unfair treatment based on gender but I did not pursue this. Instead because I knew both my supervisor and manager wanted me gone I let things follow it’s natural course.
Please keep in mind that at no time did I have any disciplinary issues. The only issue was SCAD which I explained above so there was no reason for the treatment I endured my my supervisor and manager.
During my time at Aetna I was placed in a focus group geared towards enhancing customer service tools for reps and the experience for members. I was told by the manager in that group to email her should I see any issues such as incorrect information in EPDB and doc find which I did.
At the same time my supervisor reprimanded me for following a managers directive. My goal was to ensure FCR. I felt the frustration of members who utilized the website for provider information only to find out it was incorrect. This lead to multiple calls about the same issue and depending on the rep,the member woukd be given more incorrect information or provided correct and verified information.
It should be noted that I was one of the reps who took the time to cross reference both EPDB and doc find as well as Google to ensure the information provided was correct.
Given the nature of members often they will call and after you address their concerns they will engage in conversation.
On one occasion I believe in October 2017 a member was giving me stock advice during and after handling his concerns. Although upon review of the call you can hear me trying to end the call because this was not Aetna related and his issue was resolved, my supervisor felt it necessary to reprimand me for it.
Ironically a month later in November my supervisor is coming to me asking me for the same stock information he reprimanded me on taking. He even pulled the call to review further for that information.
In summation, I would like to say that employment at Aetna Blue Bell has been interesting to say The least.
My experience there in my opinion goes against the values expressed to me in the interview. The work environment for Part C is very unprofessional and improper. Integrity wise,I was told during interview that because of the amount of customer service call center experience and me having a bacjelors.degree that I would start at a higher rate than the 16.00 per hour only to find out later that was untrue.
Per one training regarding doXXXXentation I learned that all doXXXXents created must be preserved. During my time there I doXXXXented each and every call taken from.training to my last day, citing failures in first call resolution incorrect information given website issues lack of materials sent in a timely fashion wrong information on id cards etc.
I wanted to be fair and advise you because I have also submitted a letter to CMS advising them of how call avoidance by way of utilizing SMT’s is advocated by supervisors, how members routinely call about the same issues with little to no timely or effective resolutions.
I.also.adcised them of my I’d number so that if needed they can check my computer and review the doXXXXentation of calls to verify my allegations.
Because I fear retaliation or further black balling I will not state my name.
I am writing you in hopes that you will address the things I advised you of. I do not think that with the merger of CVS and talks of a merger with Humana later that having a part of Aetna shut down for a year by CMS unable to take new members would do Aetna or it’s mergers any good.
Unlike my supervisor and manager I want to be fair. And unlike my experience at Aetna I wish to remain true on my own values of honesty integrity and trustworthiness.
Thank you for your time I am hopeful you will make the necessary changes so that future employees are not subjected to the favourtism,targeting ,unprofessional and distracting work environment that I was.
To Aetna:
First off your call center is a joke, 2nd to you all that think that providing your credit card information for billing purposes to expedite the process in getting your refills by Aetna’s RX Home Delivery is a good ideal think again. They will change the amount on the authorization without your permission and even bill a credit card even after telling them to remove the card for future purchases on there web site. 3rd I laugh about the corrupt, dishonest so called health Insurance. Here’s my point to all the hard working people in America. Call up any creditor and tell them you are only going to pay them 10 cents on the dollar. Just think how long that your electricity will stay on. But yet insurance companies decide what they will pay and guess who gets stuck for the rest of the bill. What a scam and look who’s the sucker you are ! Well I can’t wait till this so called Obama Health Care Tax is repealed I’m done with this snake oil. I’s rather drop dead than pay for this horse manure.
I agree as a former call center rep
9-20-2017
Notice ! .. Refund of Quarterly Premium Payment
Attn: CEO Mark T. Bertolini
CFO Shawn M. Guertin
In July, I made application for supplement insurance to my Medicare plan. Initally, all seemed to go well. I received notice for first quarterly payment .. and it was made on 7-26
and mailed on 7-27. In August, I received notice that the payment had not been received. I called and was asked to fax a copy of the check .. which had been deposited by Aetna and returned to my bank by 8-2. I received a letter on 9-1 stating that my coverage had been denied due to no payment. I called again .. explained what had happened. I was put on hold .. etc .. and finally asked (Karen .. supervisor?) to return my call after an investigation of the checks whereabouts was found. To date .. I have not gotten a response.
Note: I have received 2 membership cards .. one after the denial letter !
This is unacceptable ! I am requesting a refund of my check .. by close of business on September 30, 2017. I also want written assurance that my personal / medical information provided in the application process be deleted from your system.
I am not comfortable with an insurer that cannot assure even the most basic transactions
are safe.
9-22-2017
To: CEO Mark T. Bertnolini
Follow up to above comment ..
I was told today that my check deposit was found and applied to my account. Good to hear after 7 weeks and a half dozen calls .. and the second membership card is valid .. no one returned any call to me per my request. I am covered by Aetna supplemental insurance until 10-31 .. the month of Aug was lost due to .. an unnecessary run around. I will do some thinking before I continue with Aetna. As stated above, if you cannot handle the most simple transactions efficiently .. then why should I trust you with my health care?
I have been in the aging field for over 25 years .. this is unacceptable business practice. Good customer service is an expectation and the best plan for the money .. as many are on fixed incomes with little or any savings. One trip to the hospital could empty a bank account.
Also, I will make this information available to some on my resource list. It is important to shop wisely. Seniors share a lot of information by word of mouth .. and they will get the word out. Technology is great but, nothing is better than good personal service.
J. Carci
Dear Mr. Bertolini,
I am a Supervisor for a Home Health & Hospice agency that will now have to Discharge a Terminally ill Aetna patient who has less than 6 months to live because Aetna refuses to pay for the hospice benefits his spouse is entitled to through her employer. I have called Aetna numerous times, spoken with numerous Claims agents and their supervisors, I have been on hold for up to 5 hours at a time and to date there is still no solution to my claims issue. I am always told that my claims will be expedited and will pay in 3 days that Aetna knows what they are doing, Aetna understands Hospice and hospice billing and to allow more time.
I finally received my first check today, only to find that our hospice payment was short by over a thousand dollars because it was processed as a Home Health Claim and not as a hospice claim. I have explained to your claims agents and supervisors, again numerous times that this is Hospice and it is paid by the day, not by the visit. I have also explained the reason we are paid by the day is because the hospice is responsible for paying for all of the patient’s medical needs. When a patient is admitted to hospice the hospice must pay for all of the patient’s medical supplies, medications, hospital beds, ambulance rides, hospital stays, respite stays and so forth.
We cannot afford to treat this patient any longer and pay for all of his medical care when Aetna is paying per visit and per day Nor can I afford to waste 5 or more hours a day on the phone with Aetna trying to clear this up.
I hope you and your Aetna staff sleep well tonight knowing that you are responsible for the dying patient and his spouse suffering because you refuse to allow this patient access to his wife’s employee heath care benefits supplied by you, Aetna.
Sincerely
Lisa DiBeneditto
Agreed Aetna has not changed their ways and things are only worse. Misinformation, inaccurate information, obstruction, negligence, fraudulent business practices, unfair payment practices, inappropriate claim denials, obstruction of appeal process, the list is endless. There is no accountability from this entity.
I have been off work since July 20, 2017. I have my short term and long term disability with Aetna. The process is a night mare, paper work faxed 2 times and Aetna reps state didn’t receive. I also sent certified. The reps for this company are rude and have no customer service skills. I pay for this policy and have to fight to get my money…How would they like no income, not able to pay bills. I can see that Aetna code of ethics is not for the customer but to line their pockets.. I’m only giving a few days then I will go to the state insurance, attorney general, and who ever else
July 29, 2017
Aetna
151 Farmington Avenue
Hartford, CT 06156
To COO:
Attention: Ms. Margaret M. McCarthy
Presently, I am facing a family crisis involving my sister, Mrs. Carmen Collazo, although my sister’s condition, from the writing of this letter, does not qualify as an emergency, it does in fact, by her medical doctor, considered to be extremely urgent.
If you were to check the data entries under my sister’s policy #: W213417376, you’ll learn that I’ve been in contact with your call center repeatedly to get my sister the benefits that she’s entitled to receive as per her policy, and to this date she has not. In its place, what I am getting is stonewalled by your polite speaking staff call center employees that reassure me that things will be handle appropriately, but the truth of the matter is that they are not. Instead, what I had to deal with was with an impertinent bilingual employee who didn’t want to work with me; but more so, he refused to speak to my brother-in law in Spanish, which would have remedied the problem. How utterly disgraceful is that? A bilingual employee who was hired, not so much for his proficiency, but more so for his bilingual status, the pinnacle of your business, and he refused to remedy my sister’s needs. My sister who is the recipient of your policy, at the time, was in the hospital under emergency conditions hooked up to a dialysis machine and unavailable to come to the phone. Yet, that employee refused to help!
It is obvious that employee does not know or understand how much of a marketing assist his ability to speak a second language means to your company. In addition, it is equally disheartening to know that you have supervisors who were placed in leadership positions to supervise these employees to ensure that these types of problems are avoided. Yet, these supervisors don’ solve the problem, simply because they don’t care.
In conclusion, I like to know how would you rectify your lower tier employee problem, but more importantly, I like to know how you are going to solve my sister’s problem, so that she can start receiving the in-home care that she needs?
Should have questions or concerns, please contact me directly on my cell phone at: 206-715-XXXXx
Yours very truly,
L. A. Andino Jr.
Unacceptable customer service! I’m a behavioral health group provider and have spent hours on hold, with a variety of call centers with no results. An application was made 4/3/2017 for a rendering provider – there is still no resolution, and no consistency regarding records of our applications/re-applications/correspondence with you – – help!!!!
Please respond quickly – – –
Thank you.
I am totally disgusted by you “We Join You” ad with the cackling woman who sounds like Hillary Clinton . Not only is that disgusting enough but for an insurance company to air an ad that sounds like someone with pseudobulbar affect or how someone in the stages of ALS sounds is unbelievable! I have a friend who’s son recently died Of ALS and I heard how he sounded and if she heard this ad she be reduced to tears. Take the STUPID ad off the air!!!!!!
To Mr. Mark T.Bertolini, or anyone there who can resolve this:
I am a psychologist in private practice. Recently, I have changed to an S Corp. Every other insurance whose panels I am on, have made this transition relatively smoothly – all except Aetna. My biller has spent two months unsuccessfully calling to try to resolve this, and being given reference number after reference number, and receiving conflicting information by customer service representatives. Literally hours of time with Aetna, for which I am paying. I myself do not have the time or the ability to continue hitting a wall over this.
I have always received remittances of my full amount for every client who carries Aetna. For reasons I can not fathom, since transitioning to an S Corp, Aetna has begun sending me remittances that are $31.33 short of what is owed on every claim. This has happened for numerous payments. I am unable to download EOBs from Navinet with no explanation, and have to have my biller waste more time hunting them down. The only thing Aetna has done right, is transmit erroneous payments to my new business checking account.
This situation has caused problems with my record keeping and accounts, with my clients who are utterly confused by Aetna’s screw up, for my biller, and for my peace of mind.
Can someone in your corporate office clean up this mess for me. I would be eternally grateful.
Sincerely, Kate Michaud, PhD
I am having the same problem at Kate Michaud. I’m being reimbursed less than have of what Medicaid reimburses and cannot get anyone competent or anyone who cares to help with this. I will withdraw from the Aetna network if this is not fixed right away because I’m making less than minimum wage with the numerous phone calls I have had to make. Maybe a better route is contacting the insurance commission.
For the attention of Mark T. Bertolini / CEO
Dear Mr. Bertolini:
I have been insured by AETNA Health Insurance for over 40 years. Originally the insurance was paid for by my employer but when I retired I was given the option of continuing my coverage privately. I chose to continue and through American Express everything has been to my satisfaction for thirty two years. Perhaps because I have never needed the coverage. My wife and I are now in our seventies and blessed with good health. My current policy number is AMX 140116. We live in Germany and have been
dealing with your UK Office.
My problem is the dramatic increase in your premiums. Recently, they have escalated over 20% per year! As a result I will not renew.
I saw you in a CNBC interview this week and that prompted me to write.
I think I have talked to every one at AETNA International in the UK but to no avail. I have explained that I have never used the policy but that German law requires that everyone who lives here must have health insurance. I have repeatedly explained that the monthly premium exceeds my Social Security and that German health insurance is not available to me. Their age cut off is 64. I will soon be 73.
On a whim, I filled out an AETNA on line application. When I filled out the Information on my wife (dependant), I was informed that AETNA cannot cover a German citizen who lives in Germany!! What have I been paying for all these years?
Perhaps you can help me get some clarity on these issues. Even though last year’s premium is still higher that my Social Security, I have offered to continue if the premium remained the same. They turned me down. Over $1300 per month AND $5,000.– excess
is what I have been paying but now they want over $1700 for the same plan. Not to mention that my wife cannot get coverage. Something’s not right.
Sincerely,
Sam Brustas
How can I get a call from the office of the president? I am tired of dealing with incompetent call center staff who are poorly trained and outside the USA. We were approved for a pre-certification for a few providers. After submitting weekly claims for one single provider, they continue to provide EOB’s with different values every time. With the same provider and same pricing and payment, how difficult is it for claims and member services to provide the same coverage amounts each week? Must be very hard. Their member services is offshore and have the dumbest people working. I have never seen more incompetent employees in one department and company than with Aetna. I highly encourage everyone to run from using this provider. You will have more stress and frustration trying to correct their stupid mistakes 4-5 times per claim.
this company has now passed bcbs and comcast as the most useless company to deal with. after incorrectly putting my address into your computer system i have both a bad address and no ins card. after spending 1-2 hours on the phone i still have been unable to get the correct address entered and i still have no card. thank you for transfering me allllll over your phone system. letter to ceo to follow, maybe he can read. jim lawless
My husband RAYMOND CALLAWAY, SR., has AETNA MEDICARE via his retired employer. I’ve utilized the plan more so than he and never relay cared much for it as everyone states,” the best insurance you can have!” Well let me tell you here as I did in my letters to your CEO, CFO and COO. First of all let me congratulate you possibly on NOT having or utilizing this insurance that you represent, as I pray that you will never happen to be treated during a time of need as a piece of paper rather than a human being!
My husband though 82 years old this year, never a serious illness to date, suffered a stroke on July 9, 2016. After much misdirection from doctors and staffing our home town at tone nearby ER, he was eventually medi-vac to Marietta GA WellStar Kennestone Hospital, where a great surgeon and excellent neurologist save his life. From a neuro aspect, he recovered, but a series of setbacks, delirium, UTI, sepsis, lung collapse, near kidney failure, and an abdominal abscess awarded us a sixty (60) day stay 100+ miles from home from July through September. Several time the doctors worked to get him discharged to an LTAC facility due to the abdominal abscess and the recommended administration of antibiotics per the infectious disease team. Once AETNA denied the LTAC we solicited care because records states, “patient is not yet ready to be discharged to ANY facility!” This was a point well taken but note that a comment was made from one of your precert representatives (Vanessa) that she was never going to authorize precert for this member regardless! Nonetheless, as we experienced one setback after another and because of my husband’s faith and endurance to live, his condition flourished; never to the point he was able walk out of Kennestone, but better and with recommended care from a LTAC he could experience a whole healthy and happy life! Not to be done according to “paperwork” and processing a patient via “paper” and never as human being (one of your family members)! For days we prayed hoped and cried out to the Lord that we could gain precert auth from AETNA MEDICARE to a LTAC facility, within AETNA MEDICARE’S network back home, 100+ miles in Macon. Not to be done after review 1,2, 3 independent review, peer-to-peer review with a very angry neurologist on our behalf working to convince not another doctor but the bureaucratic bullXXXXX of the insurance industry; in this instance AETNA MEDICARE……after jumping through every loop and hoop AETNA required, still “DENIED! The “paperwork” only reveals the patient requires SKILLED NURSING CARE!” Problem again, there appeared to be no SNF in Macon, that upon review of his clinical that felt as if they could successfully meet the patients needs. Each denial to accept felt my husband would initially benefit from LTAC, but nooooooo, AETNA says NO! Finally my daughter convinces, or more like begs an in network facility to accept my husband as the WellStar physicians want him discharged to begin rehab to SURVIVE! The facility initially failed to review because once the insurance company was revealed, they commented, “absolutely not, because, AETNA does not want to payoff!”… More sad news from supposedly great people (or company)! We take the SNF they transport my husband and before THREE hours could transpire and we sign the initial admittance paperwork, your recommended SNF calls the local ambulance service to have my husband transported to the nearby hospital because he became agitated and was squirming around and nearly out of a chair and the administration of Haldol or Seroquel didn’t work immediately and “we are not staffed to have someone sit or watch him!” Simply put, “MEET HIS NEEDS!” He had to urinate, no one there had to time to discern that through communications with him, so he squirms, yes wanting to get to a restroom; he can’t so he sits in urine and urine soaked clothing and continues to squirm. He’s not been at your recommended SNF long enough to be assessed, receive any therapy, physical speech or any other, so he’s “labeled” agitated, drugged up, and off to the local hospital versus being approved for the LTAC facility next door to this SNF that can’t help him, for one that can, could, and would ultimately help him persevere! So tell me now AETNA MEDICARE CEO, CFA, COO, what do we do now! I expressed my displeasure, my concerns, and released all my emotions on your representative Charity, I believe was the young lady’s provided name who knows she cannot help me, but insists she will get answers, but I DO want and deserve answers, I want reviews, I want authorization from YOU, to carry out your mission, vision, and values in allowing your policyholder the right to LIFE, and the right to access care for a quality of life that will benefit his remaining time here on earth. Please look at this and know that something is detrimentally WRONG with this and do something to help remove and/or correct this mess that you manage! I’ve left out additional details that your public, shareholders, board of directors and company peons and others should know, but mine is a mission right now to GET THE PROPER TREATMENT for my spouse!
My son Cecil Thompson passed away last month 2015. All information requested from benefactor and place of employment provided. Benefactor was told it will 5 to 10 days to review and process claim. This time already elapsed. Each Claim and Review personnel (half-a-dozen) gives me same excuse as if I was born yesterday. I have worked at few Insurance Company before I retired.
You talk as if you care and sensitive and how you want to help! All we are asking is that Aetna do the right thing. My son met his obligation to Aetna whilst he was employed by Charlotte Observer and paid for his Insurance benefit.
Thank you.
Cecil Thompson stepfather Ramjeet Singh (704) 729-XXXXX
As a Humana HMO member, I understand that you have bought out Humana Co. You paid $65 Billions for this transaction. Please see this news in local news papers. This buy-out means to Humana members and how it helps Humana members?
I am an Aetna Agent I have only gotten paid for less than 15% of policies written, I have sent numerous spreadsheets and probably 20 calls trying to get this straitened out with broker support and commissions I have to support my wife my sick aunt my 4 yr old and triplet infants. I havent made a house payment in 3 months now and havent been paid money owed since may. All this for no mistake of mine I have records of probably 100 emails back and forth trying to straiten this out. I feel so defeated and discouraged because I cant get paid for the work i have done. Now my family suffers
James
For the past four months Aetna is overpaying our claims for Medicare Advantage line of business. We have called countless times through provider services and issue has not been resolved. Today I called corporate headquarters and switchboard operator refused to put me through to someone who can help in resolving this issue and instead put me through to Philippines folks who are unable to help. Then I was transferred to Florida to a provider service representative who again does not have capability to do anything. As per new system and guidelines representative must fill out a request form and forward to provider relations and someone is supposed to reach out to you via phone or email.
If you are lucky you will get an email with a copy of contract and that’s about it.
I do have all copies of our contract, don’t need another one. All I need Aetna to look at their system and verify that reimbursement rates for Medicare Advantage line of business is loaded correctly.
If everything is loaded correctly then I need a formal letter from Aetna stating that rates are loaded correctly and as a result claims are being processed correctly and there are no overpayments.
Is that too much to ask for?
I hope CEO of Aetna gets a chance to review these comments and to be able to understand how hard it is for providers to reach out to someone who really can be of some assistance.
I am a 64 year old disabled member of aetna.When I agreed to join your plan I was told by
your agent who was trying to sell me your coverage that my Orthopedic Doctor who I have been with for many years was available under the Aetna plan.He out and out lied!
As a result I wound up with a outstanding bill of several hundred dollars and had to find a new doctor.A woman I know from church also a senior citizen had the same problem also lied to by a agent who obviously had one goal sell us Aetna.I will be leaving your plan in November going with UPMC.Prior to writing you I found numerous complaints about Aetna online.What kind of person is CEO,,Mark Bertolini.How can he sleep at night knowing he will some day have to answer to GOD. Mrs. Patricia Shimrak…