There were folks in Texas and in a few other places there were not as lucky and did lose their doctors, like in Texas as I posted last week.  There’s another deal though too with doctors being a “preferred” provider with insurance carriers so when it comes to contracts and staying within what they see as “normal” moving from the preferred category can be the first step towards moving closer to the door.  552 doctors across the US were cut from Aetna. 


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Aetna Notifies 130 Texas Doctors That It Will Terminate Their Contracts on July 1 – E & M Codes Primary Levels 4 and 5 Billing Analytics For Peer Comparison Used To Substantiate the Decision – Video

Other bad news though from Aetna for California customers is that the rates are going up and even the Insurance Commissioner is up in arms about the excessive charges.  This was from last week.  Sound like it’s getting hard even for Aetna to keep track of who they are cutting off with physicians

Aetna’s 8% Rate Hike for Small Businesses in California Excessive Says State Insurance Department But Nothing They Can Do About It


At any rate if you are a customer in California their “rogue” letter mailing algorithm gotcha.  You know if they can’t get the letters right how do they do

with claims and their business intelligence I wonder?  I guess ok as they are still making millions in profits and paying shareholders. 
This is yet one more “Attack of the Killer Algorithms”, all chapters at the link below with more links:)



Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012

Last year Aetna did pull out of Colorado and the effective data of that move is August of 2012 for individual health insurance policies. 

 



For those those who have lost their doctor who are members of Aetna, there’s always “The Life Game” online that you can play and become a social heath gamer and probably give away some data for sale while you are at it or go to Best Busy to where they are hawking healthy software for consumers. 

Aetna To Offer Online Game Social Game For Personal Wellness- Joins Humana As They Have An Online Game Called FamScape

If only the same focus and care went into customer relations as does the work and efforts on games that probably collect data for sale perhaps some of those rogue algorithms that kick out letters by mistake could be kept in check:)  BD

 

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Aetna says letters mailed to thousands of its California customers mistakenly telling them their doctors were no longer in the insurer's network were not related to the health insurer cutting 552 doctors from its network nationwide.

The Hartford-based health insurer did not cut any medical providers in California as part of the changes to its network.

"In no way were the mistaken California letters related to that issue," said Aetna spokeswoman Susan Millerick. "The network is always evolving and this was a basic manual error."

The Sacramento Bee reported Thursday that more than 8,000 Aetna customers received letters in the mail in recent days, which mistakenly told them their health care provider is no longer covered in the insurer's network.

"The terminations in the system triggered auto-generated letters to be mailed out, notifying members that their provider was no longer participating in Aetna's network," Millerick said. "We have rectified the problem and are in the process of mailing out retraction letters to members and notification letters to the providers who were terminate.

http://www.courant.com/business/connecticut-insurance/hc-aetna-california-customers-20120406,0,7869846.story

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