Insurance reimbursed us - now says they reviewed the file and we owe them $1000!!!

[Anonymous]

I just received a letter from Aetna stating that they reimbursed OT for my DS in 2015 and after reviewing the file realized they applied the wrong rules and we now owe them $1000 - to be paid now!

Has anyone else had a similar situation and appealed OR got put on a payment plan?

[Anonymous]

So irritating, OP. They can go back and keep adjusting and yet we have to work within the confines of the HSA calendar year. I can't go back and pay for the expense with that money because service dates... good luck.

[Anonymous]

File a better business bureau complaint. You can do it online. I bet this charge will go away quickly. I've had good luck with something similar with an insurance company.

[Anonymous]

Anonymous wrote:File a better business bureau complaint. You can do it online. I bet this charge will go away quickly. I've had good luck with something similar with an insurance company.

Only if they don't really owe it. If they really do, no dice. They should look at their policy closely and appeal if necessary.

[Anonymous]

Agree with PP who says appeal. Just wanted to point out that most plans have deadlines for appeals and they are firm. Usually it's 30 days. So if you think they are wrong then don't sit on this. The bad news for you is that if they are correct then they can stop paying your other bills to recoup the money and that's really a hassle for you.

[Anonymous]

How much did they reimburse you originally? So, they are saying they gave you too much initially, right?

[Anonymous]

Ugh, Aetna sucks (well, they all suck). I'd definitely send them a scathing letter informing them that their screw-up - if it even was and isn't just a belated attempt to avoid their obligations as your insurer - is unacceptable, not your problem, and you will not pay what you consider a fraudulent charge. Write directly to Mark Bertolini (CEO) and don't mess around with low-level CSRs, who are trained just to deny your appeals full stop. And visibly copy your Congressman and state insurance regulatory agency/commission on the letter. They are there to protect you!

[Anonymous]

When I reread my policy they are right. They should not have reimbursed us and they made a mistake. The issue is that I did not know when they reimbursed me that it was an error they made and now I do not have $1,000 sitting around to cut them a check.

I can make a payment plan but I think it is ridiculous for them to say months after being reimbursed that it was an error and I owe them $1000 to be paid immediately.

[Anonymous]

Same happened to me with geico.
Car accident was not our fault and they paid medical bills and for our car. But they paid what the other insurer also paid
They have sent it to collection s and have been hounding no us to pay.
It's really annoying. I know they did double pay,but still it was their mistake and the whole thing was annoying
But yes I tried to fight it and we owe it back

[Anonymous]

Anonymous wrote:Same happened to me with geico.
Car accident was not our fault and they paid medical bills and for our car. But they paid what the other insurer also paid
They have sent it to collection s and have been hounding no us to pay.
It's really annoying. I know they did double pay,but still it was their mistake and the whole thing was annoying
But yes I tried to fight it and we owe it back

Oh no, this is your fault - you accepted a double payment knowing about it. That's fraud.

[Anonymous]

In the span of a week I got a bill from Aetna for almost $300 for lab work I had done a YEAR ago, plus a check from Aetna for almost $300 for a hospital visit almost TWO years ago. Luckily they pretty much cancelled each other out money wise but I can't for the life of me explain why we're getting random bills and reimbursements so long after the date of care. I'm on eggshells constantly waiting for bills to pop up years after the fact. It's criminal.

[Anonymous]

Universal healthcare is even worse, people just pay cash

[Anonymous]

Anonymous wrote:How much did they reimburse you originally? So, they are saying they gave you too much initially, right?

Our child gets OT weekly - so on a monthly basis our bill is about $700. The period they are disputing is a 4 month period where they reimbursed ~30% of our costs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Same happened to me with geico.
Car accident was not our fault and they paid medical bills and for our car. But they paid what the other insurer also paid
They have sent it to collection s and have been hounding no us to pay.
It's really annoying. I know they did double pay,but still it was their mistake and the whole thing was annoying
But yes I tried to fight it and we owe it back

Oh no, this is your fault - you accepted a double payment knowing about it. That's fraud.

It is not fraud unless done with fraudulent intent. Sheesh.

It is, however, a mistaken payment that must be repaid.