So I went to my Dr. Bold's office for some eye redness issue I have been having. I also went back for a follow-up. For both of these visits, the Dr.'s office informed me that I am supposed to submit the claims to Aetna since it was a medical visit and they are not contracted to cover medical issues with Aetna. I did as requested.
After speaking with Aetna, they informed me that the Dr.'s office IS in fact contracted through IMed to cover these visits. Basically, the Dr.'s office needs to refund the payments I paid up front and submit the costs to Aetna. I was only supposed to be responsible for my normal co-pay.
The Dr.'s office denies that their office contracted this way and have been avoiding my and the Aetna's calls. They are being very uncooperative and are convinced their contract doesn't cover medical services. Aetna even did the research with their provider services to confirm that the Dr's office is wrong. The Dr.'s office is not returning any calls and is being unresponsive. I do not understand why they won't even talk to Aetna. I am growing frustrated with this and want to know if I have any legal grounds that I can charge the Dr.'s office with. All I want is to be reimbursed and to have my claims processed properly as instructed by their contract with Aetna.
I'm afraid that if Aetna cannot get a hold of Dr. Bold's office to work out the issue, that it will never be resolved. I do not understand how his office can legally not abide by their contract. I'm not sure what else to do.
0 comments