Aetna says to Drs. No Med. Certs

njjel · September 2002

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 · September 2002

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 · September 2002

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 · September 2002

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

Don D · September 2002

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 · September 2002

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 · September 2002

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 · September 2002

Marcus Welby would turn over in his grave.

Rockie · September 2002

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 · September 2002

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

Don D · September 2002

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 · September 2002

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 · September 2002

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

Lori B · September 2002

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

PAhr · September 2002

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 · September 2002

When malpractice premiums and BMW prices went through the roof.

Aetna says to Drs. No Med. Certs

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