Aetna says to Drs. No Med. Certs

njjel

Just heard this one today. Aetan USHealthcare supposedly has advised their network of physicians NOT to fill out Certificates of Health for FMLA leaves in order to stay out of the middle (or words similar to that). Has anyone else heard about this or encountered it?

Lori B

We use Aetna and this has never been an issue (yet). I would suggest calling your rep and perhaps your broker to have a chat about service expectations.

sonny

ditto the above, I would call.. go to the source and get the facts as to the truth.. "supposedly".. could just be a rumor or misunderstanding.

njjel

My employee saw the letter, but couldn't remember the exact wording.

Don D

When Aetna says they want to stay 'out of the middle', perhaps they lose sight of the fact that being in the 'middle' requires the existence of two 'ends' and the doctors are on the 'end' where the money is received. Sounds to me like Aetna is shooting the podiatriast in the foot with such a patient unfriendly assessment. Does Aetna think they are the only game in town?

njjel

Unfortunately for those of us in southern New Jersey Aetna is almost the only game in town - Amerihealth is the other. I could not believe that Aetna is advising physicians NOT to fill out health certifications for FMLA!

Marie

My own doctor is in the Aetna Network and he has a sign in every examination room that states there will be a $20 charge for completing any forms. I don't know whether that came from Aetna or just his administrative staff.

Don D

Marcus Welby would turn over in his grave.

Rockie

DITTO! It's really sad that healthcare is coming to this. Doctors are rapidly getting the same reputation as attorneys (no offense guys!). I work for a large physician group and I see this every day. There are still some good, dedicated physicians that remember why they went to med school but they are getting few and far between. When the old income drops below half a mil a year, they start to scream!

Theresa Gegen TX

Probably Aetna is refusing to pay any charges for filling out the forms. That would not be surprising!

Don D

Not quite Theresa. This is a conglomerate which controls physician clinics I think. I don't think this relates at all to the insurance company allowing this charge on a claim although they certainly don't do that, any of them, if it's a separate line item. We had an hourly ee earlier this month who had to have ingrown toenail surgery. Normally a simple operation, he would have to miss four days due to the steel-toe shoe requirement here. The physician refused to complete the FMLA paperwork. The nurse (who always runs the clinic anyway) said, "We're not about to fill out these papers just for a toe!" I advised the ee to go to another doctor, which he did.

vmiller MO

I have not had this experience with Aetna. I have had doctors refusing to complete the Medical Certification unless paid $25.00. This requirement then presents an interesting issue. Who pays? The company or the employee? My clients have taken the position that it is the employees responsibility.

njjel

We make it clear that the payment of any required first round medical documentation is the responsibility of the employee.

Lori B

See the post about "who pays" in the main employment forum today. The discussion compliments this topic nicely.

PAhr

This is rediculous. Check off a few boxes and write out a sentence or two about the diagnosis and they want $25.00 . When did they legalize robbery?

Don D

When malpractice premiums and BMW prices went through the roof.