Unbelievable!

Well, Aetna is up to their usual tricks again. What else is new?!?!? This time, it's absolutely ridiculous. We filed our appeal on August 17th and faxed additional info on August 27th. We faxed and overnighted all of these documents when we requested our predetermination for coverage back in July. All of a sudden, the paperwork we sent them on August 27th is "new" information. Interesting, to say the least.

They told us that once a formal appeal was opened, they would allow Daniel's doctors and therapists to do peer to peer reviews. Wrong-o!!! So far, Daniel's doctors and therapists have called for peer to peer reviews, and they have been rejected. His therapists tried calling the same week we filed the appeal, and they were told one hadn't been filed. The flaw in that is that Frank FAXED everything for the appeal, and they most certainly did have one opened on August 17th. Yesterday, they refused to let our pediatrician do one, and they even hung up on her. Nice! I confirmed with our neurologist's nurse that he tried to call late last week, and he was turned away - for a 2nd time!

Apparently, they don't get it. I will not be bullied, and I will not give up on making sure Daniel's therapy is covered as mandated by Illinois law. This is getting rather old.

They did talk to Daniel's developmental pediatrician, but it was only AFTER we faxed them a second copy of documentation stating he meets the criteria for autism spectrum disorder. They never intended on speaking to any of Daniel's doctors about his healthcare needs. Now, they're suddenly interested because they are bound to cover therapy by law. I'm sooooo tired of all these antics.