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Appeal Payment of Anesthesia

I want to appeal the payment of the Anesthesia. They charged $2400.00 for their time in the OR and Aetna only paid then $30.00. So now they send me a bill for the rest. I want to appeal to Aetna to pay more or agree with the Anesthesia folks to accept another amount. I am not good at writing these things so looking for some advise. According to Aetna they do not have a contract with the Anesthesia company which is why they only paid $30.00. It's crazy that they have a contracts with the hospital, and the surgeons but not he Anesthesia company. You would think that they would all be in concert.

Thanks in Advance..

Connie

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I want to appeal the payment of the Anesthesia. They charged $2400.00 for their time in the OR and Aetna only paid then $30.00. So now they send me a bill for the rest. I want to appeal to Aetna to pay more or agree with the Anesthesia folks to accept another amount. I am not good at writing these things so looking for some advise. According to Aetna they do not have a contract with the Anesthesia company which is why they only paid $30.00. It's crazy that they have a contracts with the hospital, and the surgeons but not he Anesthesia company. You would think that they would all be in concert.

Thanks in Advance..

Connie

My advice is to make sure you have all the facts, and then be firm but respectful. Think of how you would respond if you were on the other end. I read an appeal letter posted on another board that the writer called kick-a** letter, but she had a very in-your-face attitude that I thought was a real turn-off. There are real people reading those letters and they are going to respond more favorably to a respectful letter than a nasty one.

  • 3 weeks later...

I want to appeal the payment of the Anesthesia. They charged $2400.00 for their time in the OR and Aetna only paid then $30.00. So now they send me a bill for the rest. I want to appeal to Aetna to pay more or agree with the Anesthesia folks to accept another amount. I am not good at writing these things so looking for some advise. According to Aetna they do not have a contract with the Anesthesia company which is why they only paid $30.00. It's crazy that they have a contracts with the hospital, and the surgeons but not he Anesthesia company. You would think that they would all be in concert.

Thanks in Advance..

Connie

Try to appeal stating that you did not have an option to chose an in network provider and had to use the provider set up by the hospital. Sometimes you can get an exception because the hospital surgery and stay was approved. Just an option. Otherwise see if the provider would be willing to negotiate a one time rate with the insurance company.

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