Guest guest Posted July 28, 2005 Report Share Posted July 28, 2005 I got Aetna to reprocess my claim. It took 3 phone calls to incompetent customer service people who were not willing to research, and 3 emails through their website, where I quoted various Aetna Clinical Policy Bulletins that helped my case. They kept saying, yes, it's medically necessary, but your plan excludes orthotics. Finally, someone saw my emails who knew what they were doing. Because the shoes were billed on the same invoice as the brace, they are considered an integral part of the brace and cannot be denied. Now that I think about it, I bet I'll have to do this all over again when Livi needs new shoes - I won't be buying the brace again, just the shoes, so they won't know from the invoice. Oh man.... I think they'll pay 70% since the s are out of network. But hey - that's WAY better than nothing. If anyone needs help with getting Aetna to pay, let me know and I can direct you to the right CPB. But even with that, I pointed it out to them 2x before they decided to agree with me. Just don't stop trying and eventually they'll pay!! Darby Livi 3.15.04 p/m fab 16/7 Quote Link to comment Share on other sites More sharing options...
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