Ask or Ye Shall Wait

So…

On January 16, I mailed to Aetna two claim forms for doctors' visits that were NOT covered by Aetna (what a surprise!).

About two weeks later, one of the two claims showed up online as having been received and submitted. The other was not mentioned.So I waited. And waited. And waited some more.Fast-forward to March 3: I called Aetna. After waiting on hold for about 10 minutes, I spoke with a representative. I explained the situation to her, and upon her investigation she discovered that the claim was “on hold.” It seems that the form was missing the doctor’s tax-identification number and diagnostic code… and therefore Aetna was unable to process it.I asked why I hadn’t been contacted about this. I t was explained to me that an “explanation of benefits” should have gone out to me 21 days (THREE WEEKS - the standard amount of time that Aetna waits to send out such an explanation) after the last time that an Aetna representative “touched” the account… which had been on January 31.

Now, if my math skills are of any use, then the “explanation of benefits” should have been mailed to me on February 20… or, about TWO WEEKS AGO. The woman on the phone said “oh, it’s likely already in the mail on its way to you.” Yeah, right. A single piece of paper, folded in three, takes two weeks to travel to Rhode Island. NOT EVEN AT CHRISTMASTIME does it take that long!Of course, I called the doctor’s office to share the tale with them… and they pointed out that the diagnostic code was RIGHT THERE ON THE ORIGINAL FORM.

If I hadn't called, this whole thing would have remained in limbo. And why does Aetna wait THREE WEEKS before informing its subscribers that it won't be sending payment due to a problem with the submitted forms????

Anyway... now the process begins anew. I can look forward to waiting several more weeks for Aetna to get its act together.

Aetna sucks.