Aetna short term disability

BrownBrokeDown

Well-Known Member
Just wondering how many people have experienced the same type of issues I have had. Rude and inconsistent information too say the least. It's been a comedy, lol.

Before procedure:
Told will get a call the day of procedure to verify I did have procedure
Day of procedure:
no call
Day after procedure:
no call
2 days after procedure:
I call them. I am told they have everything they need.
4 days after procedure:
I get a call stating they need paperwork from the doctor when I do my followup. Then told they would be reviewing and approving/disapproving claim 2 days before followup (7 days after procedure). I ask repeatedly how can you approve/disapprove without all the paperwork. Response "That is the way it works." I call my claim manager. She says, "no, we have everything we need, but yes we are approving the claim on that day and will give you a call."
7 days after procedure:
no call
8 days after procedure:
no call
9 days after procedure:
I call them. "no, it's too early to approve your claim. It will be processed 11 days after procedure."
11 days after procedure:
I get a message on my phone stating that claim was approved to date "a". Problem is doctor said a week after that. I call them and the claim manager is on vacation. I leave messages.
23 days after procedure:
It is today. Still no call from my claim manager. I cannot get in touch with her. Luckily, I still have a month to get that last week taken care, because it will probably take that long, lol.
 

BigUnionGuy

Got the T-Shirt
Before you spend money on a lawyer.... Or threaten them with one....


Write them a brief letter, outlining the problems.

Send it certified mail.... with a short time indicated, for them to respond. (72 Hrs)

Lack of any response from them.... file a grievance. It's a contractual violation, to not be provided with benefits.


The whole key in any situation like this.... is a paper trail.

As long, as you do your "due diligence".... being a "reasonable" person.... you will have better results.



​-Bug-
 

Stonefish

Well-Known Member
Before you spend money on a lawyer.... Or threaten them with one....


Write them a brief letter, outlining the problems.

Send it certified mail.... with a short time indicated, for them to respond. (72 Hrs)

Lack of any response from them.... file a grievance. It's a contractual violation, to not be provided with benefits.


The whole key in any situation like this.... is a paper trail.

As long, as you do your "due diligence".... being a "reasonable" person.... you will have better results.



​-Bug-

If it were me I would speak to my BA and see if he could make a call to labor if AETNA isn't responding properly. They may be able to help.
I agree sending everything certified or get a fax confirmation to have a paper trail.
If you are in the Central under Article 14 you have to exhaust the appeals before filing a grievance.
 

BigUnionGuy

Got the T-Shirt
If it were me I would speak to my BA and see if he could make a call to labor if AETNA isn't responding properly. They may be able to help.
I agree sending everything certified or get a fax confirmation to have a paper trail.
If you are in the Central under Article 14 you have to exhaust the appeals before filing a grievance.


File early....

File often....



​-Bug-

 

BrownBrokeDown

Well-Known Member
So far I have been able to straighten everything out except for the last week. I just find it incredibly frustrating, and was wondering if this is normal "processes" for Aetna. The amount of misinformation was ridiculous. I have another job that I had to file STD as well, and the difference was astounding.
 

Work safe or not at all.

Well-Known Member
So far I have been able to straighten everything out except for the last week. I just find it incredibly frustrating, and was wondering if this is normal "processes" for Aetna. The amount of misinformation was ridiculous. I have another job that I had to file STD as well, and the difference was astounding.
What kind of STD requires disability?! You must have it bad....
 
I had the exact some problem with them Brownandbrokedown. I was out for six weeks because of a ganglion cyst removal on my wrist. Dealing with Aetna was probably one of the worst experiences I've had with any company.
 

Catatonic

Nine Lives
So far I have been able to straighten everything out except for the last week. I just find it incredibly frustrating, and was wondering if this is normal "processes" for Aetna. The amount of misinformation was ridiculous. I have another job that I had to file STD as well, and the difference was astounding.
It is normal.
You are out of work and since Aetna/Metlife/UPS is paying your STD, it seems they think you have nothing else to do.

On a side note: People who receive benefits from the government go through the same processes.
It is very hard and you have to be very persistent to actually get government benefits.
 
Just wondering how many people have experienced the same type of issues I have had. Rude and inconsistent information too say the least. It's been a comedy, lol.

Before procedure:
Told will get a call the day of procedure to verify I did have procedure
Day of procedure:
no call
Day after procedure:
no call
2 days after procedure:
I call them. I am told they have everything they need.
4 days after procedure:
I get a call stating they need paperwork from the doctor when I do my followup. Then told they would be reviewing and approving/disapproving claim 2 days before followup (7 days after procedure). I ask repeatedly how can you approve/disapprove without all the paperwork. Response "That is the way it works." I call my claim manager. She says, "no, we have everything we need, but yes we are approving the claim on that day and will give you a call."
7 days after procedure:
no call
8 days after procedure:
no call
9 days after procedure:
I call them. "no, it's too early to approve your claim. It will be processed 11 days after procedure."
11 days after procedure:
I get a message on my phone stating that claim was approved to date "a". Problem is doctor said a week after that. I call them and the claim manager is on vacation. I leave messages.
23 days after procedure:
It is today. Still no call from my claim manager. I cannot get in touch with her. Luckily, I still have a month to get that last week taken care, because it will probably take that long, lol.
It sounds to me that teamcare couldn't have come fast enough.
 

BrownBrokeDown

Well-Known Member
It sounds to me that teamcare couldn't have come fast enough.
I will admit it. That very thought crossed my mind. The only main 2 things I am worried about is if my family gets to still go to our doctor, and my wifes PET scans every 6 months. Currently when she has them, the office puts in 3 total claims for about $7000.00 and I pay $27.00 total since it is considered an "in-network office procedure" for her.
 
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