health insurance not paid?
My health insurance company (aetna) who i switched from didnt pay more than half of my bills for 2006, 2007 and I have free health insurance through my job. I have been fighting with them for 2 years and it has never been resolved . Now the comanies are coming after me and threatening my credit report. What is the best way to mae AETNA pay for the health insurance bills which are covered through my plan?
I apologize, I was in such a rush I didnt put in more details....They keep saying they will handle it..buts its been 2 years, sometimes they lie and say its dine, but no one has recieved payment. They blamed it ona computer glich a few times...Basically everything was covered through them they just havent processed the payment. None of the unpaid bills I have are unpaid because they are not covered. They all should have been paid over a year ago.
- LoriLv 61 decade agoFavorite Answer
Depends on the reason they didn't pay. If you feel they should have been covered, you need to follow the appeals process. Always in writing and in this instance, certified mail. If you don't get a response from them, you could contact your state's Insurance Commissioner's office for guidance.
EDIT: Since you posted more info, I say again, send your written request (certified) and demand these claims be processed, and CC your state's Insurance Commissioner's Office. After 2 weeks, call and see what has been done. If nothing, write another certified letter as above...Keep doing this until the claims get processed. Although I don't think you will have to write more than one certified letter.
- sarah314Lv 61 decade ago
You haven't given enough information. We need to know why the claims weren't paid.
Did the provider actually bill claims to Aetna? If so, what was the reason for the denial?
Did you follow the appeal procedures of your plan after receiving the denial? Generally, you only have a limited time frame after a claim is processed to make an appeal.
If you followed all of the appropriate appeal procedures, the next step would have been to contact your state's Department of Insurance.
(This is just general advice...you'd get more specific and relevant answers if you let us know why the claims are being denied.)Source(s): 15 years working for health insurance companies and medical providers
- 4 years ago
Yes most health insurances will pay for an abortion. You need to call the customer service number to your insurance and talk with an agent. They will tell you what they will or wont cover.
- Anonymous1 decade ago
Not sure what "didn't pay half my bills" means. Did they fail to process claims, did the provider fail to submit claims, or is this your portions that the insurance didn't cover?