You are absolutely the worst company I have ever had to deal with in my entire life. Ever since being diagnosed with breast cancer in September 2010 at the age of 30, I have had to fight you on a handful of claims which you initially denied and were WRONG.
Let's take a trip down memory lane, shall we. When I was so sick from the chemotherapy and other crap going on with my body, I received an explanation of benefits (EOB) from you denying a head and CT scan that my medical oncologist ordered because of chronic sinus infections. It was denied because I didn't have a referral. I fought with your "helpful" rep about this for a good bit of time because I was on medical leave. I even told her, "Look, I have cancer. I'm off work. I have all day." Only then did she realize that my sane, rational argument that the specialist, who I did have a referral to see, had ordered that test, and saying that he couldn't order any scans for me (again, the doctor in charge of treating my cancer) was ridiculous.
After two go-arounds, the rep did an about face and said, "Oh, it was a mistake," and said she'd resubmit the claim.
Or how about the time I received a bill for $14,000 from AGH with no information on its bill, just that I owed more money to them than I had to my name. It took me two hours, and three of your representatives (someone who thought to look in my past history to see what actually happened, instead of just telling me, "I can't help you) to figure out that YOU did not pay the hospital for my last chemo. Someone apparently thought that six months into my treatment that I all of a sudden I had secondary insurance and YOU WANTED TO KNOW IF THEY WOULD PAY THIS AND NOT YOU. Because of that, I spent two hours of my life arguing with representatives and so-called hospital customer service representatives who kindly told me, "We have a payment plan." "You don't understand. I'm not going to pay you $14,000."
Or Aetna, how about the three or four times you denied the blood work that my PCP ordered or that my medical oncologist ordered because of your favorite, "Lack of referral." Yeah, I even had them say I didn't have a referral for a blood test that my own PCP ordered. That one, of course, got re-submitted.
Or Aetna, you piece of shit company, how about when you denied my claim earlier this year when I went to urgent care for a fever and bronchitis, and your EOB eloquently stated my claim was denied for a lack of referral. ISN'T THAT THE FUCKING POINT OF URGENT CARE, YOU FUCKERS? Of course I didn't have a referral for Urgent Care because it was 8 pm and I had chest pain. After arguing with the representative, who I had to point out that Urgent Care's website stated that it accepted Aetna, the geniuses at Aetna figured out the specific doctor I saw wasn't in network but the facility was. Claim resubmitted. WHAT A GREAT SYSTEM YOU HAVE THERE, AETNA.
Now, yet another claim was denied, with Aetna saying I didn't have a referral to see the breast surgeon who removed my breasts. Earlier this year, I asked my PCP office to make sure all my referrals were up to date, because, and I quote: "Aetna is a piece of shit company that's going to try to get out of paying whatever they can."
I'm sure they'll find a way to fuck me over because I'm a professional sickie and I cost them way too much money. My body's tendency to produce tumors and its lack of thyroid is just a money sucking drain. Sorry, Aetna, I'm going to keep needing my blood check for my thyroid levels and tumor markers . You're going to have to deal with it.
This, my friends, is why people think the healthcare system is fucking broken. Because it is.