Aetna Billing Issues

[somarco]

Has anyone had issues with Aetna failing to bill their clients? I just conducted my usual 90 day audit of commissions and discovered 4 clients who were terminated in the first 90 days after the policy was approved.

I have heard back from 3 of them (all 4 on direct bill) and none of them were aware their coverage had been terminated.

This is a major problem.

 

[Crabcake Johnny]

I wrote my sister's kids on Aetna years back and had my sister set up on direct draft. They failed to debit for 3 months and when I called they stated that she had not remitted any premium.

I went over that she was on direct draft, then they proceeded to hit her for 4 months at once.

 

[souldeux]

Has anyone had issues with Aetna failing to bill their clients? I just conducted my usual 90 day audit of commissions and discovered 4 clients who were terminated in the first 90 days after the policy was approved.

I have heard back from 3 of them (all 4 on direct bill) and none of them were aware their coverage had been terminated.

This is a major problem.

When I worked as a claims guy in a doctor's office, Aetna was my worst nightmare. We had a stack of unresolved cases on an empty desk known as Mount Aetna representing (literally) hundreds of thousands of dollars that they simply would not acknowledge they owed. The problems we had with them were ridiculous, even when compared to companies with barely any market share in Georgia - World, Imerica, and even MEGA weren't as bad.

So, although I haven't had the same problem with commissions, it certainly does sound like something they'd pull.

 

[bill3173]

If you can work thru these problems with Aetna, you can build a bigger book with them, than some of the other carriers that are sold constantly over the phone.

It doesn't seem that there is as much competition for their business, possibly because the average agent can't afford to, or is unwilling to work thru their pay cycles.

 

[Crabcake Johnny]

I tend to disagree with building a bigger book. Keep a family on one of their plans when they get the "double whammy" - new age rate tier and rate increase. You also have zero renewal options with Aetna clients as they keep the plan.

 

[moonlightandmargaritas]

Thank god they have uncompetitive ifp rates here...

 

[Crabcake Johnny]

I find everything about Aetna to be lacking from broker services to client services. I agree - thank God they are the highest priced carrier in MD and I don't have to deal with them anymore.

 

[somarco]

Commissions are one thing. When prodded, they eventually pay me although it would be nice for them to do right by the agent without reminders.

What concerns me more is leaving my clients out in the cold. They are human. If they don't get a bill, they don't think to call the carrier and ask if they want the premium.

So what happens when they suddenly have a claim, only to find out Aetna has not billed them in months and never sent out late notices or termination letters?

 

[moonlightandmargaritas]

So what happens when they suddenly have a claim, only to find out Aetna has not billed them in months and never sent out late notices or termination letters?

I have faced this situation before. It's the #1 reason why EFT is the ONLY payment mode to choose.

If they're on EFT and the company doesn't draft, the onus is on the company.

If they say, "hey, I never got a bill to pay", ...they're SOL.

 

[bill3173]

What concerns me more is leaving my clients out in the cold. They are human.

Where are you finding these cold humans?