04/01/2020
Warning to all of those with Aetna Health Insurance. Aetna is processing and approving claims for licensed Physician Assistants
(PAs) and applying the Specialist Physician higher Co-payment instead of applying the lower Primary Care Physician (P*P) co-payment.
Please check your Explanation of Benefits (EOBs) for copays and if you find that you have been charged a Specialist Physician copay after seeing and being treated by a Physician Assistant, please file a grievance with Aetna and immediately file a formal complaint with your State's Health Insurance regulatory body. Don't wait for Aetna's response as your medical provider/facility will be attempting to collect monies not legally owed to them based upon Aetna's current illegal claims processing policy.
The end result could be your account being sent to collections based upon the unethical behavior of the insurance company and the healthcare provider/facility.