Apr 2, 2012

Aetna Deselecting 130 Texas Physicians

Aetna has notified 130 Texas physicians it will terminate them from its networks on July 1, TMA's Payment Advocacy Department has learned. Aetna says it told the physicians a year ago it was concerned about their billing patterns. Evaluation and management (E&M) codes were the only ones Aetna examined, and its concern involves primarily levels 4 and 5 E&M codes.


Anonymous said...

google dr attacks aetna
read the hartford conn. online news about the way aetna drops drs. for no reason economic credentialing

Anonymous said...

"Physicians caring for Texans"? Who's kidding who? When are doctors going to get together and STOP THESE INSURANCE COMPANIES from telling doctors what to do???? These insurance companies continue to make OBSCENE profits, raising premiums, denying claims and laughing at the medical profession. Enough is enough!!!

Anonymous said...

How does Aetna have the arrogance to admit that these 130 docs cost them too much from their bottom line? What about the patients they're leaving in the lurch? Anybody care about them?

Anonymous said...

listen to Dr Tedeschi converstaion about Aetna on youtube.
Then read the response from Aetna spokes person. in hartford press. 2 days ago.it is only the beginning

Anonymous said...

Aetna spokeswoman Susan Millerick.

First, the ARROGANCE of flaunting the fact that 'we don't HAVE to give these doctors reason for termination, so we won't.' (They don't even refer to us as 'doctors,' but rather, 'providers.')

“Our contracts with these providers do not require us to show cause for termination,” she said. “Therefore, we have no cause to share."

Second, these 'customers' she's talking about are patients who will be left out in the cold with no doctor as of June 12th . Do these patients sound like they are concerned with 'smaller networks that are less expensive to maintain?'

"We took this difficult step in response to customer demands for smaller networks that are less expensive to maintain."


Anonymous said...

Does Aetna maintain your practice,YOUR OVERHEAD?????
The insurance cos caused the overhead to be higher, the referrals the diagnosis codes. etc!!!

Anonymous said...

Perhaps I should communicate to my employer that they should not offer Aetna to my family?

DaveR said...

Don't worry, TMA will have another meeting with Aetna to make it feel better. This has been brewing for 15 years and had we grown a spine then, things might be different today. But we'll never know, will we? Keep those dues coming though. We need 'em to fund those carrier meetings.

Steve Levine said...

Thanks to all for your comments. Much appreciated.

A few notes and updates:

1. We added the link to Dr. Tedeschi's YouTube video and the Hartford Courant article to our main story on this problem.

2. TMA has made a big difference for Texas physicians on this issue. In the early 1990s, we restored numerous physicians to Aetna and Humana provider panels by suing the companies for their malodorous "deselection without cause" policy. TMA secured legal protections in Texas that require Aetna to tell physicians why they are deselected. We then shamed major insurance companies into meeting regularly with TMA physician leaders and staff to resolve members' reimbursement problems through establishment of the TMA Hassle Factor Log© that allows physicians to document reimbursement hassles.

Finally, I had to delete "Neurology's" post. The federal government could interpret his calling for physicians to boycott Aetna a "restraint of trade" and get us in a heap of trouble.