AETNA: Computer Error Overcharges Patients
An Aetna computer programming error caused about a dozen companies to overpay for discounted medical services, the Wall Street Journal reports. The problem occurred when a computer coding error charged patients in Aetna's National Advantage Plan, a new "'indemnity' program covering 80% of most medical expenses after a deductible," a percentage of the full price for services instead of a portion of the discounted rate. According to Aetna spokesperson Jill Griffiths, program "enhancements" made in April erroneously affected coding and caused providers to receive "explanation of payment" forms showing incorrect patient charges. While the incorrect forms did not call for physicians to bill patients, "some may have done so," Griffiths said, adding that Aetna will "refund those dollars" for anyone who overpaid. She also noted that a "coding correction is in place and will be effective [today]." Aetna declined to name the companies involved in the National Advantage Plan or how many employees might be affected by the error. One customer, Dow Jones & Co., publisher of the Wall Street Journal, actually alerted Aetna to the problem after receiving numerous employee complaints. The Journal notes that the computer problem was one in "a series of setbacks" for the insurer, whose performance has "disappointed investors and depressed [the] stock price" (Martinez/Hensley, 8/25).
Amidst it problems, Aetna is making changes in its executive leadership, according to the Hartford Courant. CFO Daniel Messina left Aetna U.S. Healthcare and will assume the role of executive vice president and COO at Magellan Health Services Inc. on Sept. 18. Alan Weber will become Aetna U.S. Healthcare's CFO and Marty Rosen, head of health communications, leaves this fall and will be replaced by Roger Bolton, Aetna Inc.'s senior vice president of corporate communications. Aetna CEO William Donaldson said in a memo to employees that with the changes, the company "completed the task of blending the corporate and health organizations into a cohesive whole" (Levick, 8/25).