Wiki Aetna and antepartum care

[debellis59]

Hi everyone:

We had a patient (Aetna coverage) who had antepartum care that crossed over the 2024/2025 year change. She had four antepartum visits, so it was billed with 59425. There was no plan/coverage/group change for the new year. Aetna is denying it wanting it to be broken out by year. This has happened before with them, then they deny because it isn't done as 59425. It's a merry-go-'round with them and, quite frankly, I'm fed up with them. We nearly dropped them this calendar year, but somehow decided to go ahead and keep accepting that insurance. Any suggestions on how to deal with this?

So far it's ONLY Aetna pulling this nonsense.

Thank you,

Deb

 

[nielynco]

Hi everyone:

We had a patient (Aetna coverage) who had antepartum care that crossed over the 2024/2025 year change. She had four antepartum visits, so it was billed with 59425. There was no plan/coverage/group change for the new year. Aetna is denying it wanting it to be broken out by year. This has happened before with them, then they deny because it isn't done as 59425. It's a merry-go-'round with them and, quite frankly, I'm fed up with them. We nearly dropped them this calendar year, but somehow decided to go ahead and keep accepting that insurance. Any suggestions on how to deal with this?

So far it's ONLY Aetna pulling this nonsense.

Thank you,

You can complain on this practice both to ACOG and your State's Department of Insurance on behalf of the patient. That frequently gets results (or has in the past), but given today's climate, who knows.