Valley Medical Care has always filed insurance claims as a courtesy to our patients and will continue to do so. Many plans including the State of Alaska plans changed to Aetna this last year. Unfortunately working with Aetna has proven to be difficult and time consuming for our staff. Due to Aetna claims not being processed in a timely manner and the inordinate amount of time we spend trying to resolve non medically related issues with Aetna, claims that are 90 days old will be transferred to your responsibility and payment will be expected from you.
The best way to avoid delays in your insurance payments is to be proactive. Below are some of the areas that have caused the most concerns and delays.
-- Aetna sets their own usual and customary (UC) fee schedule and it may vary depending on your particular plan(s). They also have their own list of services they deem medically necessary for your care. Services that don’t fall under that list will not be covered. If you have questions about charges for services, please call our billing department before your appointment and we can give you the pertinent information you will need to contact your insurance.
--Aetna coverage for preventive service differs from the previous state plan. If you are coming in for your annual/physical which may include vaccines, contact them prior to your visit.
--Many Aetna members are having difficulty sorting out which coverage is their primary insurance causing lengthy delays or nonpayment. Contact Aetna as soon as you see a problem, as well as with the VMC billing department. Keeping us aware of any change in status enables us to reprocess claims when necessary and reduces long processing time.
--You should be receiving an Explanation of Benefits (EOB) for each visit from your insurance company. You should save them and if you don’t receive one within 30 day of a visit, please contact Aetna. Often times they are holding claims waiting for information from the member.
--If you are a union member and unable to resolve an issue with Aetna contact your union. They should be able to help resolve your problems.
Always keep our billing department informed so we can do our best to get your claims processed as quickly as possible.
Aetna 855-784-8646 Valley Medical Billing 907-586-2482