Reply to Don't believe Aetna phone support-Preauthorized treatment denied!

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[quote=Anonymous]I had a similar experience with Aetna this past June.  According to our benefits, my son is supposed to have unlimited occupational therapy services for habitual services.  The OT department and I both called Aetna for pre-authorization of services.  After going for two months, Aetna claimed because he is not diagnosed with Autism or Down Syndrome, they did not consider his condition to be habitual.  Stuck us with a bill for $400 in services.  We got documentation from his therapist and his pediatrician that stated the services were not for rehabilitative purposes.  My son was born with his condition and needed occupational therapy to gain life functioning skills.  We filed 3 rounds of appeals and eventually won.  His services, however, were interrupted for 4 months while we went through the appeals.  Unfortunately, after winning the appeal Aetna came back and claimed my son's benefits would expire on his birthday because he would be turning 19.  My son was turning 9 not 19.  Took another two weeks to fix that fiasco.

Bottom line, Aetna sucks.  Get another insurance plan at open enrollment if you can.[/quote]

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