Guest guest Posted January 24, 2010 Report Share Posted January 24, 2010 Why don't you qualify?? From: sList [mailto:sList ] On Behalf Of Gabi Sent: Saturday, January 23, 2010 6:20 PM To: sList Subject: Warning re: Aetna and ABA sessions Hello everyone, I know there were a couple of parents here who were trying to get Aetna to pay for their kids' ABA session so beware! We had our son's plan of treatment approved and over 60 sessions authorized by Aetna, in spite of us asking several times if they were sure we qualified. Yes, Yes, yes all the time. On Wednesday after calling to figure out why we were being denied reimbursement for some of the sessions, I was told that Aetna was denying all sessions because we didn't qualify. HUH? Yeap, they are also asking for the money back... So.... Has anyone being in a hole like this? Lol, I have to laugh, it's unbelievable! Any advice? Thanks in advance... Gabi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2010 Report Share Posted January 24, 2010 Why don't you qualify?? From: sList [mailto:sList ] On Behalf Of Gabi Sent: Saturday, January 23, 2010 6:20 PM To: sList Subject: Warning re: Aetna and ABA sessions Hello everyone, I know there were a couple of parents here who were trying to get Aetna to pay for their kids' ABA session so beware! We had our son's plan of treatment approved and over 60 sessions authorized by Aetna, in spite of us asking several times if they were sure we qualified. Yes, Yes, yes all the time. On Wednesday after calling to figure out why we were being denied reimbursement for some of the sessions, I was told that Aetna was denying all sessions because we didn't qualify. HUH? Yeap, they are also asking for the money back... So.... Has anyone being in a hole like this? Lol, I have to laugh, it's unbelievable! Any advice? Thanks in advance... Gabi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2010 Report Share Posted January 24, 2010 Why don't you qualify?? From: sList [mailto:sList ] On Behalf Of Gabi Sent: Saturday, January 23, 2010 6:20 PM To: sList Subject: Warning re: Aetna and ABA sessions Hello everyone, I know there were a couple of parents here who were trying to get Aetna to pay for their kids' ABA session so beware! We had our son's plan of treatment approved and over 60 sessions authorized by Aetna, in spite of us asking several times if they were sure we qualified. Yes, Yes, yes all the time. On Wednesday after calling to figure out why we were being denied reimbursement for some of the sessions, I was told that Aetna was denying all sessions because we didn't qualify. HUH? Yeap, they are also asking for the money back... So.... Has anyone being in a hole like this? Lol, I have to laugh, it's unbelievable! Any advice? Thanks in advance... Gabi Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2010 Report Share Posted January 24, 2010 , we're a 10-people group, the mandate is good for plans of 50 or more employees. I knew that going in and even sent them a copy of the mandate text along with all docs reports, assessments, etc. Kept hearing from our " behavioral care planner " that everything was fine, and that we didn't qualify per the mandate for up to $36K for ST/OT/ PT, because those therapies weren't proved to work as treatment for Autism... But ABA was toooootally different. I made several calls to the claims dept because there was always something wrong with the reimbursement but then the care managers always dismissed those mistakes as that, they didn't know about ABA... BS, now I know better. > > Why don't you qualify?? > > > > From: sList [mailto:sList ] On > Behalf Of Gabi > Sent: Saturday, January 23, 2010 6:20 PM > To: sList > Subject: Warning re: Aetna and ABA sessions > > > > > > Hello everyone, I know there were a couple of parents here who were trying > to get Aetna to pay for their kids' ABA session so beware! > We had our son's plan of treatment approved and over 60 sessions authorized > by Aetna, in spite of us asking several times if they were sure we > qualified. Yes, Yes, yes all the time. On Wednesday after calling to figure > out why we were being denied reimbursement for some of the sessions, I was > told that Aetna was denying all sessions because we didn't qualify. HUH? > Yeap, they are also asking for the money back... So.... Has anyone being in > a hole like this? Lol, I have to laugh, it's unbelievable! Any advice? > Thanks in advance... > > Gabi > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 25, 2010 Report Share Posted January 25, 2010 Aetna just dumped us. We had Aetna from a contract job then through Cobra. We never used it because of how bad they are with ASD stuff we just paid out of pocket while keeping the Aetna as a back up for things like an accident plus for future insurance companies not labeling our son as pre-existing.. When hubby got a job offer we needed to finally see Kiddos Dr's for prescriptions that would last while we tried to find new Dr's . So after using Atena for 2 Developmental ped appointments Aetna sent us a letter that they where dropping us.We even pay for perscriptions out of pocket. Plus they are now being a pain about sending the letter saying we had insurance. Aetna no like ASD families. > > Hello everyone, I know there were a couple of parents here who were trying to get Aetna to pay for their kids' ABA session so beware! > We had our son's plan of treatment approved and over 60 sessions authorized by Aetna, in spite of us asking several times if they were sure we qualified. Yes, Yes, yes all the time. On Wednesday after calling to figure out why we were being denied reimbursement for some of the sessions, I was told that Aetna was denying all sessions because we didn't qualify. HUH? Yeap, they are also asking for the money back... So.... Has anyone being in a hole like this? Lol, I have to laugh, it's unbelievable! Any advice? Thanks in advance... > > Gabi > Quote Link to comment Share on other sites More sharing options...
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