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Welfare and Pension through Emdeon....= Aetna???

Messages
3
Location
Anchorage, Alaska
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I wonder if anyone else is having difficulty with Welfare and Pension regarding electronic claims submission?
I received a hospital facesheet indicating an address and phone# for her insurance carrier. I called and the automated system says,
"Welcome to Welfare and Pension Provider Line" it goes on to tell the caller to "Submit your claims electronically through Emdeon... which is what I did! I have proof of filing and acceptance from Emdeon and proof it was passed and accepted by Welfare and Pension.
I submitted a high dollar claim to W&P through Emdeon... as instructed to do when I called their telephone#.
Claims accepted per Emdeon submission report. Sorry to repeat myself but I am a little stunned here.
TIME GOES BY...
Patient calls and says she called them, this is months later and no claims on file, can I send to them to W&P again... I did.
Months later and past timely filing, patient calls again to say no claims on file per W&P.
I call and am told they sent out letters both times stating to send my claims to Aetna. This is past timely now
and Aetna of course denies for timely even with the information attached showing claims filed to W&P timely, twice.

Fast forward past timely - patients W&P Claims manager calls me and ultimately states I need to write the balance off because I failed to submit to Aetna timely. We are not par-providers with either company. I asked her if W&P is her insurance carrier or Aetna? It is W&P she says but they contract Aetna to receive, scrub and price the claim then send to W&P for payment. So ultimately Welfare and Pension will receive the claim in the end anyway!
Anyone else having issues with an insurance comapny requesting claims subnmittal to other than themselves and denying timely if you happen to send to the actual insurance company???
 
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