Aetna Paid Millions in Error Due to Faulty Records
Aetna Inc. has been paying some claims twice and some bills for people it no longer covers, the Hartford Courant reports. In a meeting with investors yesterday, Aetna CEO Dr. John Rowe said that about 11% of all claims need "further review or information" and 56% of those claims are duplicates. Rowe said claims are paid more than once when providers use more than one method -- mail, fax or e-mail, for instance -- of sending the claims form to the insurer. "The doctor doesn't trust that the managed care company is going to pay," he said (Levick, Hartford Courant, 6/8). He added, "We're overpaying substantially, and we're going to stop overpaying. I believe it's millions of dollars. My guess is there's more to be discovered" (Bloomberg/Los Angeles Times, 6/8). The firm plants to recover the money and take a more "disciplined" approach to preventing overpayments. Rowe said Aetna expects to have a "better management information system" running in about 40 days (Hartford Courant, 6/8). The latest news comes at a time when Aetna has lost $36.6 million from operations in the first quarter and is "under pressure" from doctors and patients who say the insurer pays claims "slowly." To boost profits, the firm is dropping 10% of its "unprofitable" clients. Shares of Aetna closed at $25.90 yesterday, up 44 cents (Bloomberg/Los Angeles Times, 6/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.