Question Telehealth/Mental Health Cost-Sharing (Covid Waivers)

lburgos31

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Has any Mental Health providers experienced discrepancies with how Aetna is processing claims for telehealth visits? I am working on a project for my Manager that we think may lead to a potential lawsuit or class action suit. Aetna process claims and applies copays then reprocesses them and takes the copay back a few weeks or month later. The problem is that majority of our patient's pay with Credit Cards which costs our practice a percentage of each swipe.

So, whether its a payment or refund we are losing money. This started at the beginning of the pandemic and is ongoing. We have lost well-over $50,000 based on this issue.

Please let me know if there are any avenues of recourse and if your practice has been affected.
 

lburgos31

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I did contact the insurance commissioner but they can only investigate fully funded plans they directed us to the US Dep of Labor for self-funded plan assistance.
 
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