Aetna RD Reimbursement issues since 2009

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I know NOTHING more about this. For those of you doing Aetna billing.

Jan Patenaude, RD, CLT

In a message dated 4/5/2012 1:34:27 P.M. Mountain Daylight Time,

president@... writes:

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From the President ...

Sylvia A. Escott-Stump, MA, RD, LDN

April 5, 2012

To all members of the Academy of Nutrition and Dietetics:

The Academy has received complaints from members about Aetna’s processing

of certain in-network claims between January 2009 and the present. The

complaints at issue relate to claims submitted by registered dietitians

in-network with Aetna for services designated by CPT codes 97802-97804,

99401-99404, 99411-99412, G0270-G0271 and S9470 when billed with appropriate

ICD-9

codes and the claim was denied by Aetna with the reason listed in the

Explanation of Benefits as “these expenses are not covered because this

provider

is not recognized under the member’s plan definition of a physician.†The

Academy of Nutrition and Dietetics has brought this issue to Aetna’s

attention. After thoughtful discussion we have reached an agreement and we are

pleased to report that Aetna has agreed to reprocess these claims and make

eligible for payment each such claim that is resubmitted.

The Academy thanks all members for their patience and support, as we work

with Aetna to resolve this issue that has such important ramifications for

members. This situation represents a vivid example of how membership in the

Academy benefits dietetics practitioners, and how the Academy carefully

makes use of members’ dues to simultaneously advance the profession,

advocate for its members and protect and improve the nation’s health.

_READ ENTIRE LETTER_

(http://mailer.eatright.org/t/13157/2648593/16697/35/)

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