Aetna erroneously terminates providers from California network
Monday, 16 April 2012 18:00

 

The California Medical Association (CMA) has learned that Aetna incorrectly issued notices to over 8,000 patients statewide advising that their provider had been terminated from the Aetna network and would no longer be accessible to provide care. This action was the result of a manual error in their provider system. The health plan erroneously allowed the termination of providers throughout their California network with an effective date of March 1, 2012. Auto-generated termination letters were then mailed to all members assigned to these terminated providers.

Aetna is in the process of issuing retractions of termination notices to both members and physicians, and has corrected their provider database. CMA has confirmed that no gap in physician participation will result from the error. Additionally, claims that may have been processed incorrectly as out-of-network will automatically be reprocessed without the need for the physician to resubmit.

Patients with concerns should be directed to contact Aetna Member Services at the phone number indicated on the Aetna Member ID card. Physicians who have concerns regarding the issue can contact Aetna Provider Services at (888) 632-3862 for PPO, and (800) 624-0756 for HMO and Medicare Advantage plans.

Contact: CMA’s reimbursement helpline, (888) 401-5911 or  This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Last Updated ( Friday, 20 April 2012 18:24 )