Guest guest Posted March 28, 2008 Report Share Posted March 28, 2008 Hi, Lately we have been having problems with AETNA ins. The front staff calls the insurance co for physical therapy. We are informed that the patient has a unlimited or 50 visits and above policy, but they do indicate that after the 25th visit they will review all medical records to see if it's medically necessary to continue therapy. It does not matter if it's 2 different body parts, it will get reviewed as one. They will let you know about the 20th visit on a EOB to send all medical records, reports, rx and letter med. nec. from us and the referring MD. We make copies of all that they are requesting and fax it over to them. It takes about 7 business days from them to at least put it in the system, but it takes about 30 to 45days to be reviewed by a medical examiner. In the meanwhile patient's are still being treated after the 25th visit. Once you receive the respond from Aetna they denied all claims after the 25th visit.They also tell you it is not the patient's responsibility. Through out all this we really let the patient now whats going on and also make them pro active in this process. Once all is said and done we are sending a final letter to Aetna and also to NJ BANKING AND INSURANCE, letting them know whats going on and also in detail of all the attempts we tried to receive payments. We will have all our patient's who have Aetna sign a form acknowledging their policy and that they might be responsible for the balance after the 25th visit if their insurance co. denies it Please provide any feedback regarding this. Thank You, Jersey Central PT .. --------------------------------- Looking for last minute shopping deals? Find them fast with Yahoo! Search. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.