Medical Billing Forum

Payments => Insurance Payments => Topic started by: JenniferPT on June 27, 2012, 09:34:13 AM

Title: Who might I send a letter to regarding an unpaid claim from December?
Post by: JenniferPT on June 27, 2012, 09:34:13 AM
I wasn't employed with my current employer at the time, but I have a claim through Aetna that does through 3rd party (Magellan) and Aetna has told me for the past 3 months they're waiting on Magellan.   I've asked for phone numbers to contact Magellan myself, which end up being wrong phone numbers, etc.  I'm too the point that I'm going to have to start writing a letter to someone.

What is the proper chain of command here?   I've spoken to 5 customer service reps about this claim and all tell me the same thing and can get nothing done.  We're in Texas, if that helps.
Title: Re: Who might I send a letter to regarding an unpaid claim from December?
Post by: Sriram_Sub on June 28, 2012, 07:00:16 AM
What is the phone number they gave you?
Title: Re: Who might I send a letter to regarding an unpaid claim from December?
Post by: Michele on June 29, 2012, 07:08:56 AM
Have you tried to look up a number for Magellan online (Google or their website)?  I would try that or do the letter.  Don't wait any longer.

Title: Re: Who might I send a letter to regarding an unpaid claim from December?
Post by: PMRNC on June 29, 2012, 07:39:02 AM
On the back of your card is a phone number to call for out patient mental health, that would be Magellan if they are your TPA.  Aetna uses Magellan and they have offices in Houston and Austin that I know of. 
Title: Re: Who might I send a letter to regarding an unpaid claim from December?
Post by: NuBiker on July 11, 2012, 08:42:53 PM
Is your employer a participating provider with Magellan? If so, maybe you can get internet access to Magellan's website.

www.magellanhealth.com/provider
Title: Re: Who might I send a letter to regarding an unpaid claim from December?
Post by: JenniferPT on September 20, 2012, 09:25:48 AM
I've gotten numerous phone numbers from the CSR at Aetna who all say the same thing.  "Let me send this to our resolution team and see what happens."   I don't even know if I can get info from Magellan, quite honestly.  They are the TPA but if I call and say, "Hey, I've got an Aetna patient whose claims used to be paid out by you, can you tell me why I'm not getting an answer almost a year later on one date of service?"   I have payment for the D.O.S. before this D.O.S. and payment for the D.O.S. after. 

It's just beyond ridiculous and Aetna CSR are zero help.   Verbatim, each phone call, I can tell them exactly what they will tell me.   I guess now I just may need to look up some address and write to someone at Magellan.