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

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[quote=Anonymous]I have had the same problem with aetna. My daughter continues to have speech therapy covered, but at the end of june last year, they decided that her OT was not covered retro back to April 1. I have no idea how to fight this. We tried getting new prescriptions for the OT with different dx, but nothing worked. Her therapist was nice enough to "write off" the fees for us, but now she's not getting OT. I can't afford it.
Now...after her developmental doc ordered a micro array chromosome test, and it being pre authorized over the phone at their office, then again over the phone to me the next day, it was denied. The test is $2700! I never would've done it if it wasn't covered. They continue to give us the run around. They told us to have it billed under a different procedure and dx code. We did that with the lab. Denied again. We called and spoke to a manager. She told us there is nothing she can see as to why it was denied. She said she'd look into it and call us the next day. She cI alled back, and said the underwriting dept (I think) deemed it "experimental testing", and these are not covered. So of course I got a letter from the ordering doctor that this is a standard of care, needed to determine future dx and treatment. Now I'm getting calls from a collections agency.
Do I need to contact an attorney? I already have a special needs child, I don't need this...[/quote]

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