I have Aetna health insurance and I need to file an appeal because they are refusing...

M

msbuckeye2u

New member
...to pay for treatment....? I went to the Minute Clinic inside of CVS to have a painful stubborn wart removed from my hand and I paid a CoPay but now I get a bill for $64.00 when I have insurance and when I called Aetna they said that they dont cover laser surgery and the Minute Clinic claims that they never said anything about laser surgery (back and forth)! The nurse used some freezing solution and by no means was it any kind of laser surgery at a CVS store! Anyone experience anything similar or have any ideas.
 
It sounds like the claim was coded incorrectly by the clinic.

Every procedure that can possibly be done in a clinic setting has a 5 digit CPT (Current Procedural Terminology) code.

Your insurance company receives the 5 digit code from the medical provider, and determines your benefits based on that.

If Aetna thinks you had a laser procedure done, then there must have been something wrong with the code that was used.

There's nothing for you to "appeal" - you just need to make sure that the claim is submitted correctly to Aetna.
 
Follow your insurer's appeal procedures. Submit documentation that it was not laser surgery. Maybe the paperwork was coded wrong - that frequently happens. Insurance billing is error-prone.
 
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