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Aetna and Bank of America, Connecticut Complaints & Reviews - Short Term Disability

Aetna and Bank of America Contacts & Informations

Aetna and Bank of America

Posted:    h8breedgirl

Short Term Disability

Complaint Rating:  63 % with 24 votes
Contact information:
Aetna/Bank of America
Connecticut
United States
AETNA has the worst disability claims analysts i've ever seen and dealt with... they are rude, liers, and just deny claims so they don't have to pay out, and side w/ whoever the company you work for...
they take their time and extend the appeals because they are too lazy to get it done right away.. I don't think the disability analyts there are qualified at all...
they also seem to take alot of days off, switch from one analyst to another...to another... why? because one can't handle the claim so they need to pass it on? that makes me laugh...qualified my butt...

THIS IS MY STORY AND WHAT HAPPENED TO ME...
I submitted my leave of absence on Aetna's workability management also, it told me i qualified for short term disability..
i printed out the papers needed to be filled out and when done, had them faxed to Aetna...
Aetna they said they never recieved the certificate from my provider..about a week later i was told this..
when they got the "2'nd" one, they denied my short term disability because my "INTERNAL MEDICINE DR" put on the certificate i had chronic depression, he had referred me to a specialist dealing w/ behavioral health, so i made the appt. and she diagnosed me with Biploar depression after i told her ALL the same symptoms to my INTERNAL DOCTOR..
he had no idea i had the bipolar part..

so i appealed it, they said wait 45 days..so i did and sent in more info they needed
then they had to "EXTEND" it... why? I sent in a letter related to my dr. appts. i had before i went on leave and after i went on leave, copies of proof, my dr. also sent in notes from those appts.
so...THEY HAD TO EXTEND ANOTHER 45 DAYS BECAUSE OF THOSE 5 OR 6 PAGES... come on... do your work right and stop being lazy and just putting it off...

SO... they did the peer report, calling my dr. and my behavioral health dr.. that i STILL see every week, along with my meds. dr..
my "INTERNAL DR." told them i was acting "NORMAL"
even after i told him my symptoms i had and it was all caused from work and the managers being unprofessional, saying things to me that should have never been said, gettin me upset, angry, crying, anxiety, etc...AND I COULD NOT PERFORM MY JOB DUTIES/HANDLE THEM...
as a result from those events and other things... i ended up depressed which turned into bipolar, real bad, was told it was manic depression also...

i was out from May 2009 until Oct. 09
i got NO benefits or payments, all my bills got behind, credit cards not being paid, had to cancel some of them and now my credit report is bad...

my appeal was only part of my leave, they denied me from May 13'th 09 to June 10'th 09 because my first appt. with my behavioral health dr. was on June 11'th 09..
so the approved part of my short term disability was approved from June 11'th on until i went back to work... which was Oct. 2nd 09

But...after my appeal was decided on Oct. 15'th or so...they denied me again because of what my INTERNAL DR. said, i was acting normal...which i wasn't...

the Aetna "DISABILITY ANALYST" named "TABITHA" kept telling me since Aug. 09 another week, another week or so before the decision, etc...
SHE LIED TO ME!!!
so i cried, my boyfriend came home, saw how upset i was and called "TABITHA"
SHE WAS RUDE, LIED, and then told him/me on speaker phone "NOT TO CALL BACK UNTIL OCT. 15'TH 09"


I had asked her in another call pryer to that one how my benifits would be paid out if my appeal was denied or approved, since i was "APPROVED" for the Short Term Disability from June 11'th on...
SHE SAID SHE DIDN'T KNOW...
WELL... this is what she should've told me because she should've known, and i didn't know until Oct. 15'th when they denied my appeal again...and when i got the denial letter and their " FINDINGS" which was the "ACTING NORMAL" part...

According to my place of employment... which is...of all the places... "BANK OF AMERICA"
do you know what their policy procedures for their "ASSOCIATES" are??

YOU CAN NOT GO FROM AN "UNPAID" MEDICAL LEAVE...TO A "PAID" MEDICAL LEAVE..

I had no clue until i got that denial letter, didn't understand and called "TABITHA"
SHE THEN TOLD ME I WOULD RECEIVE "NOTHING"
NO BENIFITS PAID OUT...
EVEN THOUGH I WAS "APPROVED FOR SHORT TERM DISABILITY FROM JUNE ON...

I called what is known as "advice and counseling" for the Bank of America, that lady told me Aetna should've known that and told me..
Advice and counseling did nothing to help me, that was in Oct. 09 after my denial letter and talking to "TABITHA" from Aetna.


SO... because they took so long on my appeal, extending it, and no benefits paid, i had to "FORCE" myself to go back to the same place that caused me to not being able to perform my job as i couldn't concentrate, focus, i cried, got angry, irritated, anxiety, dropped work a few times that was done and had to put in order again...
i lost my regular position because "BY LAW" bank of america can do that after 16 weeks on medical leave...

i was still angry and upset and worse because i was put in a position again that i could not do before "a processor", as a result given the "workflow" one that i did before my leave... that i was outcasted from...why? Because i have Tendinitis in my hands that prevent me from getting my "numbers" or "quota" for what i do..which is check processor/ check encoding...like data entry..

I know i did very good on my job, all the trianees told me i did, and i helped them more than "others" who should have, taking on their responsabilities as they weren't, and causing me my symptoms also..
workflow is only supposed to get the work, pass it out, pick up the done work, and bring to the next department..
that's all i was supposed to do...not required to answer the trainee's questions or if they needed help..that is a "TRAINER" position..
i was NOT a trainer...but doing their job on top of mine...

SO... by the 2nd day i was back to work, i cried at my machine, got racing thoughts...and still to this day, put in the training room where i worked doing workflow and watching how they "CHANGED" things in that room while i was gone to get better, which shoud've been done before i left...
and seeing the "new person" doing "MY JOB" that i had for over 3 years...
i get angrier and angrier and cry everyday that i am there...
i get frustrated and in pain from my hands hurting, doing more damage... and not able to get the "1600" items per hour...

A NEW MANAGER TOOK OVER AND MADE THE CHANGES WHILE I WAS OUT..

I HAVE TALKED TO HIM A FEW WEEKS AGO, TOLD HIM MY SITUATION AND MY DISABILTY AND THINGS THAT "HAPPENED" AS A RESULT OF MY LEAVE...
I ALSO TOLD HIM I CANNOT BE IN THE TRAINING ROOM BECAUSE I AM SURROUNDED BY PEOPLE THERE WHO CAUSED ME DAMAGE, AND THE NEW WORKFLOW PERSON, GETTING ME UPSET/ANGRY, WATCHING...AND CRYING
I TOLD HIM I NEED TO GO TO THE PROCESSING FLOOR "A UNIT" SO I CAN TRY AND SEE WHAT HAPPENS...
HIS QUESTION..."WHAT ARE YOUR NUMBERS?" NICE HUH?
I CAN'T GET MY NUMBERS...CAN ONLY DO "1300-1400" AVERAGE..
I WILL EVENTUALLY BE PUT ON WARNINGS.. THEN BOOTED OUT OF THE COMPANY AS MANY OTHERS HAVE...

I WAS JUST TOLD THIS PAST FRIDAY 11/20/09 THAT I WILL BE MOVED TO A UNIT, AFTER A WEEK OF WAITING.. IN THE FIRST WEEK OF DECEMBER..
ANOTHER WEEK OF TORTURE BECAUSE OF THE HOLIDAY THIS THURS...

SHAME ON AETNA FOR LYING TO ME...TAKING THEIR SWEET TIME, NOT TELLING ME THE RIGHT THINGS THEY SHOULD HAVE, SHAME ON THEM FOR MAKING ME WORSE...EVEN TO THIS DAY...CRYING, GETTING ANGRY STILL AT WORK, ETC.. I FEEL IT WAS "BAD FAITH" ON THEIR PART, AND BY GOING BY WHAT MY INTERNAL MEDICINE DR. SAID..
WHEN THEY SHOULD'VE GONE BY MY BEHAVIORAL HEALTH DR. DIAGNOSED ME AS...
FORCING ME TO GO BACK BECAUSE OF THEIR LAZINESS AND NOT DOING THEIR JOB RIGHT...

I NEED MONEY FOR ALL THE NECESSARY THINGS I NEED, SUCH AS MY APPTS. WEEKLY, MY MEDS MONTHLY... LAMICTAL AND STRATTERA, AND OTHER MEDS I TRIED SINCE JUNE TO GET THE RIGHT ONES..
I NEED GAS IN MY CAR, INSURANCE, BILLS, FOOD, RENT, TO PAY MY SHARE W/ MY BOYFRIEND.. ETC..
MY BOYFRIEND ENDED UP PAYING FOR THINGS THAT I COULDN'T, I OWE HIM SO MUCH NOW..
IT PUT US ON A TIGHT BUDGET; ME TAKING OUT OF MY 401K TO PAY FOR WHAT I COULD UNTIL THAT WAS GONE..
I HAD TO PAY COBRA $100 A MONTH TO KEEP MY AETNA "HEALTH" INSURANCE IN ORDER TO GO TO MY BEHAVIORAL HEALTH DR. AS THEY DON'T TAKE "STATE" MEDICAL...
AND I WAS NOT ABOUT TO SWITCH TO ANOTHER FACILITY AND START "OVER" W/ ANOTHER DR OR PLACE..
I AM STILL WORKING ON GETTING THE STRATTERA DOSAGE RIGHT, AND LAMICTAL BEING INCREASED SLOWLY...AND GETTING BETTER, BUT IT'S STILL HARD..

COME ON AETNA...DO YOUR JOB RIGHT, AND MAYBE YOU WON'T GET SO MANY COMPLAINTS..
BECAUSE I'VE READ SO MANY OF THEM, AND CAN RELATE TO SOME.. I WONDER HOW MANY "BAD FAITH" LAWSUITS YOU HAVE AGAINST YOU...

AND AS FOR MY EMPLOYER.. SHAME ON YOU TOO...WE'LL JUST HAVE TO SEE WHAT HAPPENS, BECAUSE BANK OF AMERICA ALSO HAS NUMEROUS COMPLAINTS...FROM "ASSOCIATES" CALLING HR AND COMPLAINING W/ NOTHING GETTING DONE BEFORE I WENT ON LEAVE...UNTIL THE NEW MANAGER STEPPED IN...

BANK OF AMERICA SEEMS TO ALSO CARE MORE ABOUT THE PEOPLE THAT HOLD BANK ACCOUNTS/CLIENTS, THEN THEY DO FOR THEY'RE OWN ASSOCIATES..

AS FOR BOTH AETNA AND BANK OF AMERICA, I WILL TRY AND FIND AN ATTORNEY HERE IN CONNECTICUT TO HELP BRING THIS TO COURT AND "SUE" FOR DAMAGES THEY CAUSED AND STILL ARE...

I CAN'T QUIT BECAUSE I NEED MONEY, NOT IN THE RIGHT STATE OF MIND FOR AN "INTERVIEW" WITH A NEW JOB...

IF I CANNOT FIND SOMEONE TO HELP ME, I WILL FILE ON MY OWN TO CIVIL COURT...SEND LTRS TO CORPERATE OFFICES, NEWSPAPERS, MEDIA... ETC...

HECK, I THINK I'M GONNA COPY AND PASTE THIS AND SAVE IT...

WHAT GOES AROUND, COMES AROUND...
I WILL GET WHAT I DESERVE BECAUSE OF THEIR "ACTIONS" AND DAMAGES...
COUNT ON IT...EVERYONE WILL KNOW ABOUT THESE TWO "COMPANIES"

ANY ATTTNORY WHO MAY READ THIS AND WOULD LIKE TO HELP ME... PLEASE RESPOND TO THIS AND TELL ME WHAT I CAN DO, OR WHAT I SHOULD/SHOULD'T DO I WOULD APPRECIATE IT..
WRITE YOUR NAME/NUMBER AND IF YOU'RE INTERESTED AND IF I HAVE A GOOD CASE ON MY HANDS..

HAVE A NICE DAY TO THOSE WHO "DESTROY" OTHERS...
BECAUSE SOMEDAY " I WILL"

FROM: A MANIC BIPOLAR DEPRESSION PERSON HERE IN CONNECTICUT
Comments United States Health & Life Insurance
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 29th of Jan, 2010 by   AETNASUCKS 0 Votes
Aetna with BOA is a joke...I've had similar problems with claims denied, rude and unprofessional reps, receiving mis=info from reps, claims of missing forms faxed multiple times by my medical providers, I have notebooks full of calls to them and false info given..I too worked for BOA...I was finally told after months of getting the run around...having every doctor I saw submit "evidence" of my inability to work and endless calls to Aetna..their job is to get you to go back to work...AETNA IS NOT YOUR FRIEND...THEY ARE PAID TO PROTECT THE INTERESTS OF THE COMPANY THAT CONTRACTS THEIR SERVICES...which in my case was Bank of America. They will try to wear you down so you'll give in and go back to work even when not ready...because that's what they are paid to do... The key is finding a doctor who will work with you to fight for your best interests...if you encouner a provider that's insensive to your needs or not helping you find another quick! Best wishes from someone in the same boat with Aetna.
 16th of Feb, 2010 by   AN ANGRY WOMAN 0 Votes
I am literally going through the same thing! As though being bi-polar and depressed is not stressful enough, adding Bank of America and Aetna to the the equation is your worst nightmare. I have seen incompetence internally through Bank of America and have now experienced the same through Aetna. The companies are run similarly with anyone working in positions even though unqualified to perform the task. I just received a denial for paperwork to an overturning pending review to a denial again and this is a joke. If you are unable to receive Short term disability when you are disabled then tell me How can you be eligible for FMLA? I was told that this is the next step. I have exhausted my FMLA and will now be placed on probably personal leave. If this is exhausted I will be fired or let will be deemed as voluntary quitting my position. This has been ongoing since October and I have had enough. I was told by Aetna in their Behavioral department that instead of just showing signs of depression, I am bipolar. The doctor showed signs of bipolar mania and prescribed medicine for this. What the hell is wrong with Aetna's short term disability. I am seeking a lawyer as I just received my rejection letter again for the upteenth time and I am tired of the malarky-B.S.
 16th of Mar, 2010 by   frustrated friend 0 Votes
I have been going through the same problem with B of A and Aetna. i have been diagnosed with panic disorder and agoraphobia. I keep getting the run around. I should be getting my rest and working on my health, but this has set me back. I am going to seek legal professional help on this matter. Aetna never returns calls and when i finally get a hold of them they are rude. I have sent over all paperwork requested from me and my doctors have also done the same. Im not sure what is the delay on my claim but im tired of the run around.
 15th of Apr, 2010 by   NC83 0 Votes
I went out on disability 2.5 weeks prior to my due date for pregnancy, and the denied the short term disablity claim, but now that I had the baby I have Maternity pay through the bank... They are a very stressful company to deal with, 2 weeks before you have a baby, you dont want to hear that you wont be getting paid! and im still arguing with them to approve it, the case manager said, that they can retro the date and pay if my dr changes the medical terms of why he took me out of owrk early... Also I have been having severe anxiety, and dont know if i will be ready to go back to work- So more then likely do you think they will deny that claim for post partum depression?
 10th of May, 2010 by   stressed out and pregnanct 0 Votes
I am currently pregnanct and my dr took me out of work due to vaginal bleeding and anxiety 14 weeks before my due date. Aetna is a nightmare to deal with. They re extremely rude and no one calls you back and then when you finally get a hold of them they couldn't care less and lie to you as well. My dr.'s office is disgusted with them. They don't understand how a pregnant woman suffering from vaginal bleeding cannot be approved for STD. My anxiety has worsened since I have been out of work due to the stress of worrying if I will be paid or not. The behavioral health dept (for anxiety) is different from the reg STD dept and they do not communicate...no one is doing their job. I feel the other associates on this page that say Aetna is just insurance for BOA and is not looking out for the best interest of the associate. They are right. I pay these people every month and I have yet to feel that they are looking out for my best interest.
 17th of May, 2010 by   Sharopn Hall 0 Votes
I'm filing a claim with Aetna and I work for BONY Mellon fka JPM Chase...with chronic back pain and problems with management and peers..doing work thats not in my jobe description...My position is :Documentation Associate. Managment assignment me to the Legal Review Process which included creating a "cheat sheet" so staff (including Managemen) would have this available instead of pulliing the actal SEC guidelines booklet, , Then I held a training session to review the document so employees would understand sheet and know requiresments for each scenario..now fast forward to this year...because of this extra dutie I've become the go to for legal review..which means my productions down and error ratio up...Management explanations is the constant interrruptions are cauising errors...remember I've not had a promotion.still Documetation Associate...with promise of upcoming promotion...now I have people internally and externally, peers and management calling, emails which are a constant distraction...and the few errors I've made are not monetary loss for the company...simple errors such as printing same ticket twice placing on another...we have a verification dept.long story short now I'm having anixety, stress, two herniated disk in my neck and back muscular stress ...and I need to take an extended amount of time off.
Please if anyone reading this knows what I have to do please respond...oh and BNY Mellons outsourcing jobs to India, Pa And Syracuse so any little error could cause job loss.
 19th of May, 2010 by   having a nervous breakdown 0 Votes
I am in a battle with them right now, i went out on a leave and was approved worked a reduced schedule for three days and had a relapse, i submitted paper work supporting it from my same doctor, and acct specialist ebony doctor, denied it the next day but waited 14days to tell me. this has been a horrible experiance, and has almost pushed me to a nervous break down, not know will my job be safe or not. shame on them!
 25th of Jun, 2010 by   JaneDoe 0 Votes
If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

I recently reported to the president of AETNA that the Albany, NY office had nurses that were deleting faxes and denying claims for not receiving the clinical faxes
from hospitals. Guess where that got me... unemployed. I have 5 children, single mother, and they didn't pay any severence let alone all the over time hours I worked. I advised the President of this also... he didn't care. During a recent speech to AETNA employees he joked that he wouldn't even add his own son to his insurance... he mentioned some serious health issues his son had had. I guess his priorities aren't in favor of families over money. He also mentioned the TV show where the CEO's of large companies go under cover in their own companies... he said the employees that didn't recognize the CEO's should be fired. I was really
disappointed how disconnected he was. There are serious economical issues affecting families these days. Many are working long hours and multiple jobs to get ends to meet. I know that as a single mother of 5 children, working as a RN for AETNA, I was working 60++++++ hours and not paid any overtime. I wasn't being ignorant to his importance in the company... I just didn't have the time to keep up with who's who in AETNA. I was fired 6/17/10.

The email to the President of AETNA is: S010496@aetna.com
Good Luck...

As far as speaking to a supervisor / manager... try calling:
860-748-8186 or 210-771-0214
 23rd of Jul, 2010 by   drdoom 0 Votes
I am going through the same thing now. My PCP diagnosed me with an enlarged heart and hypertension in Feb. 2010. In June, 2010, I began to suffer severe chest pains while working at BOA as a branch manager. These pains were so bad my staff made me go home early one day because I looked like I was going to pass out. When I saw my PCP for the pains, I was told by my PCP to take some time off until they could figure out what was going on since they thought it was my heart. Come to find out, my doofus PCP misdiagnosed me and my heart was fine but the pains continued and I could not function so I continued to stay out. My PCP said the pains were anxiety related after ruling out a physical ailment so I went to a clinical social worker I had seen years earlier for depression/anxiety. Aetna approved my leave from 06/11 to 07/09 but would not approve the extension to 07/23 since they said there was no clinical information to support the claim. But there was clinical support for 06/11 through the 07/09? The same information was sent both times. I can't tell you how many different analysts I have been in contact with. Also, one minute Aetna denies the claim, then they approve it, they ask for multiple documents, deny it again, and then when you call they say the claim is "under review". It seems like my claim is always "under review". The whole process is confusing and the claims analysts and case workers really act like they don't know what they are doing. One analyst was telling me about the paperwork she had received on the case so far, and when I mentioned the 4 most recent forms that were faxed in and she had missed them on the computer. If she isn't looking at all the documentation how can she make an educated decision regarding the claim? Everytime there is a claim denial, my a-hole boss calls me trying to pressure me to come back to work and this just makes my chest hurt worse. I have decided to quit BOA after my STD ends on the 23rd but am scared that BOA will back out my pay because Aetna can't get their act together. I just cannot face going back to that place and dealing with my market team. They say there is no clinical proof but my PCP has prescribed two anti-anxiety medications for me, my LCSW sees me once a week and sends detailed case notes to Aetna after each session including the forms Aetna has asked for. We all have jumped through every Aetna hoop and it is amazing to me that some analyst sitting in a cubicle somewhere is more qualified in determining if I can return to work than a licensed professional clinician. If anyone has any suggestions to help me through this process, let me know.
 24th of Jul, 2010 by   JaneDoe 0 Votes
PCP probably should have sent you to a cardiologist if not the ER to rule out any heart problems. Recurrent chest pain isn't normal. Maybe the cardiologist can do a stress test & echo to look at your heart valves etc... Next time go right to the best ER in your area. They can do cardiac enzymes & check K & Mg.
Don't give up. Sounds like the STD department needs more data. Heart Cath ? Labs? EKGs? Echo? Carotid ultrasound? CT? MRI?
Even if your physical health all checks out... anxiety that causes physical symptoms like chest pain & headaches etc should be another route to
check out & treat. Try a psychologist that is in the same office with a psychiatrist. Psychologists are great for therapy & counseling with their psychiatrists
able to possibly try medications.
Don't quit... that's exactly what AETNA & your employer would love. You paid for your benefits in the event you would need them, and you should use them.
Try calling your regular AETNA 'Informed Health Line (IHL)" on the back of your insurance card... ask for a nurse... REQUEST to be provided with a RN CASE MANAGER to help you with your "GAPS IN CARE."
Call your human resources department, ask for the insurance "liason" to inform of difficulties your having with AETNA not reviewing the information in front of them or not admitting they received it at all. Keep fax confirmation receipts as proof.
Call Supervisors at AETNA & report lack of clinical despite multiple submissions. Reviewers could be deleting them & documenting not receiving them.
Sometimes they possibly don't enter ALL information on a fax to support being able to deny your claim.
Denials can be reviwed again with additional information provided within a specific period of time. You can also initiate an appeal by calling member services. After the appeal fails, you can request a review by an outside provider not employed by AETNA.
Leave multiple voice messages and keep a record of them. REPORT WHEN CALLS AREN'T RETURNED to AETNA Management & your insurance liason ;)
Alot of stress... let your MSW help you
make a plan that won't cause too much stress on you in addition to what you're already going through.
Don't forget that AETNA wants to spend as little $ as possible & get you bak to work to save on the STD. You might be on a "high dollar list" now from your
medical & psychological diagnoses & STD use. They're watching & they're very patient with long term planning to no longer have employees that use too much
money. They also target COBRA use after termination / resignation. If they're going to get rid of you... probably won't do it at the beginning of a month because then you have the rest of the month to use your benefits.

Good Luck.
 24th of Jul, 2010 by   Panicked by Anxiety and Depression 0 Votes
Panicked by Anxiety and Depression...

I too am presently going through a very similar situation with Aetna/Bank of America. I am a Sr Account Manager in Collections. In these financially challenging times, this is a VERY STRESSFUL ROLE. Due to suffering Panic/Anxiety attacks while on the job, I was advised by my direct supervisor on 06/15/10 that I needed some time off work. He recommended that I see my PCP the following day to advise her of the constant headaches, heart racing and crying that I am experiencing. I contacted Aetna for assistance with finding a PCP in my area. After explaining to an Aetna EAP therapist what was going on, I was also referred to a LSCW (Licensed Clinical Social Worker) specializing in stress management. After seeing both the PCP and LCSW I was diagnosed with General Anxiety and Depression Disorder and having Severe Panic Attacks. They both took me out of work indefinitely meaning until my condition was under control. I was also prescribed anti-depressants and Ambien due to lack of rest which was a direct result of panic and fear of dying in my sleep. I originated a short term disability claim on 06/16. I was advised by Aetna that all documentation supporting the claim needed to be received by the 14th day following the claim being filed (07/01). Together with my PCP and LCSW, we promptly faxed back all necessary documents. I constantly called the automated system only to be notified that my claim was still under review. I pressed the appropriate key for a live person and was told that they have not received the necessary docs to make a decision. I contacted my doctors and we all faxed again. The following day 06/25, same thing… I was advised that they have not rcvd the docs. At this point I was furious… First thing Monday morning (06/28) I went to both of my providers to get copies of the docs they had faxed so that I could fax everything at one time on my own. On Tuesday I called to check the status again, of course, same story, they claim to have not recvd the paperwork. I askd this particular rep for her direct fax # so she could retrieve the fax and her direct phone # so I can call her back directly to confirm that she had rcvd the fax. I was told VERY RUDELY “NO, THAT’S NOT POSSIBLE!”. I ended the call with this rep dialed the member services # on the back of my medical card. I provided my claim # to the customer service rep and simply asked “HAVE YOU RECEIVED ANY FAXES ON THIS CLAIM???” . She advised that she can see duplicate faxes being recvd beginning 06/23 and everyday thereafter. I asked her what the next step in this very stressful process is? She explained that the claim wouldn’t be rvwd until the 15th day following claim initiation (07/02). Of course my next question was WHY ISNT THE CLAIM BEING RVWD UNTIL 07/02 IF THEY’VE HAD THE NECESSARY DOCS TO MAKE A DECISION SINCE 06/23? She was unable to provide an answer the question other than THAT’S JUST HOW THEY DO IT.
On Friday 07/02 @ 4:50pm EST … I rcvd a call from a claims manager advising that my claim was DENIED due to documentation not being received. I furiously explained that I have already confirmed that all necessary documents were rcvd multiple times. She then said the diagnoses doesn’t support the claim and that I have to appeal the decision and see a Licensed Psychiatrist for any mental health issues by the 30th day of the claim origination date in order for the claim to be re-opened and reviewed again. I continued to explain that they are the ones that referred me to the PCP and the LCSW to begin with, I asked why they didn’t refer me to a psychiatrist in the first place if this is the procedure??? Of course, my question was heavily avoided. So around I go again on this Merry-Go-Round of lies and deceit.
It was such a headache trying to find a psychiatrist that had a new patient opening within the upcoming 2 weeks. After cntcting about 25 providers, I finally found one about an hour away from my home with an opening on 07/14 but I couldn’t wait this long without being paid… I contacted my manager to update him on the situation. He advised that he could not allow me to come back to work if my doctors will not release me back. I scheduled the appointment and anxiously awaited the date while continuing to see my LCSW.
After seeing the psychiatrist on 07/14, and explaining everything that I’ve gone through prior to Aetna and while dealing with Aetna, she agreed that I was presently in no condition to return to work at the moment. She scheduled follow up appointments. The following day I cntctd Aetna to advise that I have seen the psychiatrist and ask “NOW WHAT???” The rep explained that there was nothing else for me to do but continue to go to my appointments. He advised that my claim was currently APPROVED through 08/04. He said if my psychiatrist felt that any additional time of work beyond 08/04 was necessary then she needed to submit the paperwork to support the claim extension…. AT LAST!!! After a month of being off, I can focus on therapy and getting better and not worry about Aetna and getting paid. My next scheduled pay date was Friday 06/23. All of us BofA employees know that we can go to NetBenefits on the Wednesday prior to payday to confirm all is as it should be… Well to my surprise, I didn’t have a paycheck in the system. I immediately contacted H.R. and explained THIS WHOLE SITUATION all over again… The rep in H.R. said the last correspondence that Aetna sent them was on 07/15 which said I was approved for an UNPAID LEAVE. Due to the obvious issue I have with this, she transferred me to Aetna…. AROUND I GO AGAIN…. While explaining the situation to this rep she continued interrupt by saying “Your claim WAS approved through 08/04” but just like the rep on 07/15 she purposely and deceitfully failed to disclose that approval was for an UNPAID LEAVE which was definitely not the claim I submitted for. Again I asked “WHAT IS IT THAT NEEDS TO BE DONE TO GET THIS CLAIM PAID???” She told me there is nothing that I can do but wait for the appeals process to run its course which could be up to 45 days… In tears, I explained to her that I am a woman with 3 children living paycheck to paycheck and cannot afford to go almost 2 months without being paid… She didn’t seem to care and told me there was nothing she could do. The following day I received a letter from BofA/Aetna threatening to cancel my medical insurance if I don’t pay $933.38 out of pocket due to me not having a paycheck for them to withdraw the bi-weekly premiums out of. Well how do they expect me to pay them if they are not paying me??? I have no idea what I’m going to do for medical coverage for myself and my family. In addition to all of this, due to my stress, anxiety, panic and depression worsening thanks to Aetna and BofA, my psychiatrist has advsd that pending the result of our next appointment she may be admitting me for inpatient care… AAAARRRRGGGGHHHH!!! … I’M NOT CARZY!!!… Just heavily STRESSED…. Whatz a girl to do???
 25th of Jul, 2010 by   JaneDoe 0 Votes
WOW... A new level of unethical practices.
A recent employee broadcast to AETNA employees advised higher ups were focusing on "mental health" as another high dollar trigger. The rationale
was that it precipitates long leaves of absences under FMLA protection. The STD apparently is concerning to them.
Unfortunately, I think Bank of America is one of the contracts that allows your employer to see ALL your personal health information because they are
a "self-funded" program. I think that because it's their money used to pay the claims, they can view the specifics because they are the "payor."
It raises the issue of unfairly, unethically weeding out their employees based on "High Dollar" red flags. They hide behind "RN Case Managers" that gather
all your personal health information. The RN's may actually think they're trying to help you... but they really need to be careful what they document because
it could end up being held against you unofficially. Your direct manager may be a great person, but over his / her head are statistics & reports being generated that target specific employees for potential to cost the company High Dollar in medical expenses, STD, LTD, and COBRA. I found that even when I filled Rx's paying cash & not presenting any insurance information, I still received notifications from AETNA making me aware that they knew all details, dosages, frequency, etc... it was a detailed reminder of the "Mail" benefit to get Rx's through them. I felt that my privacy was violated. There must be a national data base that gets all medicinal information on everyone no matter what insurance you use or don't use. When you don't use their mail service AETNA can make you responsible for higher RX out of pocket costs. They're very creative getting around laws that were meant to protect our privacy.
If they target you and decide you're too much of a risk, they may try to start picking through your work to find anything they can to document incompetence as a reason for terminating your position. While some states are "at will" employers, meaning they can fire you without reason, it would seem still discrimination is driving unemployment.

Try reporting the details to:
Director
Civil Rights Center
US Department of Labor
200 Constitution Avenue, NW
Room N-4123
Washington, D.C. 20210
 1st of Aug, 2010 by   barney387 0 Votes
I currently have an open case with the department of labor in Seattle Washington, but the person assigned to my case says she doesn't have any other open BofA complaints. If anyone sees this and wants to log a complaint about having COBRA benefits improperly terminated by BofA as administered by Aetna, please let the Seattle office know:
US Department of Labor
1111 Third Avenue Ste 860
Seattle, WA 98101
206-553-4244
 21st of Sep, 2010 by   rrodger9 0 Votes
I am a type 1 diabetic and have been for 30+ years. I started having severe pains in my left side. This was diagnosed as a kidney stone. I was in such severe pain that I have been unable to sleep and have been taking darvocet to try and relieve the pain. After 3 weeks my PCP sent me to a urologist who also stated that there was a stone. I went through lithotripsy to break it up but the pain persisted. The urologist sent me to a back specialist who looked at my back only & found nothing wrong. In the mean time, the pain has spread to both of my thighs and is starting up in the right side of my back. The pain is so severe that I have issues just having pants touch the tops of my legs. I am still not sleeping. The PCP finally got the correct diagnosis which is painful diabetic neuropathy, a disease that affects my nerve endings. I have been referred to a neurologist.

I had the wonderful opportunity to initially deal with Coleen Campbell at Aetna. She takes all of my information and opens the claim. She faxes the physician statement to my PCP & to the urologist. She had the wrong fax number for the urologist so they never received it. There is no contact with her at all until a couple of weeks later when she calls & leaves a message on my home voice mail that I have 3 days to get the statements in. No mention of progress notes etc...just the physicians statement. I then discover that she sent the fax to the wrong number, called her several time to advise of this & she never returned a call. I then get a letter stating that the claim was denied due to insufficient documentation. I called Ms. Campbell several times & learned that she had gone on vacation & nobody could work her cases in her absence. I finally got her about a week later. I was able to pry out of her exactly what was needed & proceeded to get her the documentation. The STD was paid through 7/19. I advised her that I had been referred to a back specialist, the date of my appointment which was about 15 days away. I went to the specialist with the physician form in hand & paid their fee to fill them out. The office manager told me that there was a 15 business day turnaround on these forms. I advised Ms. Campbell of the same. She in turn closed the claim a few days later without giving me the chance to present the documentation.

I call & call & call & call, leaving messages on her voice mail each time. I finally get tired of this & try to go up the ladder. Her supervisor is just like her...never available & never returned any calls. I threaten to get an attorney & get assigned another case worker. It turns out that Ms. Campbell was no longer with the company. This tells me that she was screwing up so bad she got fired or she was short timing on a 2 week notice & basically quit doing her job during that period. I had since been discharged from the back doctor & went back to my PCP. I requested in writing & by phone several times to have an attending physician statement faxed to my PCP. This went on for 2-3 weeks & they finally faxed one to them.The new case worker, Jennifer Dukes advised me that she understood what was going on & would do everything to resolve the issue. At that time, I got the physician statement from the back doctor and sent it in along with his progress notes. Unfortunately his notes & the form only dealt with my back which was healthy as shown by an MRI. I didn't believe that this was enough to support my claim but that the diagnosis from my PCP would tie all of it together. Since I couldn't get anyone to send the PCP a physician statement, I got his progress notes for visits on 8/11 & 8/25 which states the neuropathy diagnosis, the attempts that were being made to resolve the issue & that I was being referred to a neurologist. about 3 days later I got the attending physician statement from the PCP. It very plainly states that I had the neuropathy issue...that I had chronic pain...that I had insomnia due to the chronic pain and that I was unable to perform my duties at work. We wait again for a review & they denied the claim today.

I have called everyone in the Aetna universe today including the number given above. The person I got said she wasn't related to the claims division. She did try to get me direct numbers to the claims managers, but the one she gave me was disconnected. I talked to a CSR manager and she was supposed to have the claims manager supervisor call me or I was to hear from the CSR manager by 4:00 PM today. I didn't hear from either one. I did get a direct line to the CSR manager and called and left a message on her voice mail that has not been returned. I also started up the ladder at BOA to get our sponsor plan representative involved. It seems we don't have anyone to act as an advocate for employees on the STD or LTD plans. We have to complain to Aetna about Aetna. I also called the NC insurance Commissioner Consumer Helpline and they told me the same thing and that this would then go to the Federal Dept of Labor for complaint if they turn down the appeal.

I have contacted an attorney and have a meeting with him on Saturday.

Add to this that Ms. Campbell put in the incorrect dates for when my leave started. I have had to spend 15-20 hours on the phone straightening out what the bank claimed was overpayment for checks that I actually worked for and for health insurance premiums. The health insurance issue is still going on and has progressed to the point that they have assigned a case worker to me.

I just got a call from the CSR manager stating that they had transposed my cell phone number and that was why the claims manager didn't return my call, but they would call tomorrow...We will see.

My main issue is that there is nobody at the bank to act as an advocate for their employees & seem to be ignoring all of the issues that Aetna poses.

This time, they have picked the wrong person to mess with. I deal with contract law on a daily basis and have a good understanding of lawsuits etc. I will not back down and if need be will not hesitate to file suit against Aetna and BOA to collect what is owed.
 15th of Feb, 2011 by   hopeless30 0 Votes
In the same boat. I suffer from Bipolar 1, and recently was divorced. Aetna was great up to my second extension release. I was approved for FMLA but denied for STD. How do you pay for medical services when you're not receiving any pay?? I appealed, and will most likely end up comitting myself. I am at the end of my rope, suicide sounds soothing sometimes. I thought anyone that works in the medical field insurance, urgent care, suicide line whatever would have some type of interest in helping people. I was denied for lack of "clinical information." Yet you don't keep working with one case manager, your file gets passed down each time. I had one apparent case manager tell me, " in my professional opinion you won' t get approved for STD with Major Depressive Disorder." I told her I am bi-polar. She said, " well ok, but many people suffer from bipolar disorder and are successful." To find out she was an RN, but she did not specialize in phsychiatry, she gave me her opinion w/o me even me asking. I think her name was Nancy Riveras. Then agian they mostly work out of KY, so perhaps many people in the bible belt do not believe in mental illness. To say I have not been recieving good treatment at all. My doc has been writing incorrect notes, I was brtutally overcharged by a hospital for outpatient therapy and now they will not reimburse me. I stopped going because they were charging me too much and I didn't know. Aetna quoted what they did? Yet they failed to have a phsychaitrist helping you with meds, you only saw a therapist. They were charging me $45.00 each session, when in theory it should have been $15.00. With 28 sessions $45.00 is steap. They overcharged me about 300 dollars, I definetly could use that money being I am not getting paid now. I have no idea how to pay for my insurance which is through Aetna too. My therapist is the only medical provider that has been helpful. So I will continue not to sleep, cry all the time, continue cutting myself to find some relief. My physical health is starting to deteriote. I have tried several antiphsycotics with nothing being helpful. I am starting to hear things. I guess there really is no help. I couldn't even get my manager to return my calls when I first went out on leave. They are out on leave now, I have no idea whom to contact if I do go back. To say I'm scared to death to go back. I'm sure my unit doesn't need a weak bipolar in their unit.


~ Hopeless
 25th of May, 2011 by   ontheverge 0 Votes
I totally agree, Aetna short and long term ins. is nothing but a huge ripoff . i think this company should be put out of business . If you carry this insurance with this company and have anything happen to you, get ready for filing a welfare claim and losing your house. My advise to anyone out there with this company is, look for another insurance company as fast as you can.
 3rd of Jun, 2011 by   onlyme11111 0 Votes
Same old story here. My previous doctor actually stopped seeing me because I had Aetna insurance. He recommended that I pick a doctor from their network just in case I needed to go out on a leave in the future. He figured that if it was one of their own doctors, how could they deny me.

Well guess what…I recently had to take a leave of absence a month ago only for 2 weeks, one of which was funded by my own vacation time. And low and behold, I got denied! I thought about contacting someone at B of A but I don’t think they are going to side with me. After all, they would have to actually pay me a week’s worth of pay.

And so I just filed my appeal letter like a good little puppy and here I sit, wait, hope and pray that they will somehow develop a sympathetic heart to overturn their decision and rightfully pay me as it is outlined in my employee benefit package.
 7th of Jun, 2011 by   BrokenNoMore -1 Votes
In my situation, Aetna and its employees violated my privacy, impersonated me, exposed me to identity theft and covered it up, knowingly provided false information to my employer, harassed me, falsely quoted medical findings, confused medical records, lost sensitive documents, misapplied medical payments, violated the ADA and FMLA, and left a paper trail doing so.

The good news... We caught them, and are deciding how we will approach the situation.

I'm sure you'll hear more about this on the National news not too long from now.
 10th of Jun, 2011 by   NMA851 -1 Votes
@Hopeless - If this person who alleged she is an RN, then she would know that MDD and BP-I are TWO COMPLETELY DIFFERENT DISORDERS!! Given the history with AETNA, it comes as no surprise to me, unfortunately, and at your expense. You do get passed from one end of the company to the other, most of the employees act like they have all this medical knowledge & training yet their actions speak volumes. Hell even a common man/woman could Google the two and CLEARLY see there is a difference - MAJOR difference - between the two. With psychiatric disorders though, some (or most) of the time they overlap with other disorders which is actually beneficial for us. However one the problems with that is AETNA will get "stuck" on the ONE disorder that is easy to deny so they can delay you some more and make you go through another few weeks or months of hell, arguing, fighting, screaming, getting records, mailing, faxing, without ANY regard to the fact we can't even put food on our tables nor continue treatement(s).

For the others who have posted as well, losing paperwork in an ELECTRONIC AGE is just sickening. It is VERY rare that any medical data is on actual "paper" anymore. From what I personally know from the dealings with AETNA, anything you send them is converted into an electronic file; and you can send it via email, fax, or snail-mail. It does not matter it still ends up in an electronic format. In fact, I was advised that faxing and emailing documents AUTOMATICALLY convert what you are sending into an electronic format, time-stamp it, give it a barcode, and notifies EVERYONE who has ANYTHING to do with the case.

That being said, we can now conclude via this chronology that the problems start, continue, and if your prayers are answered with the human beings responsible for doing the jobs that OUR premiums are paying them to do. I do not care if each caseworker has 100+ cases; they all deserve the same amount of attention to properly, fairly, reasonably, and most importantly EFFICIENTLY process the claim(s). Given the hell I've been through with AETNA myself, it's almost as if these people are trained to find ONE little item that gives them the right to either delay the claim or deny the claim.

As for appeals processes - we have VERY strict time limits imposed upon us to get an appeal in. How are we supposed to exercise our rights whenever the notices have a date of (EG) June 1st and we don't receive it until June 20th giving us 5 days to gather everything and get the appeal in? The mail system is NOT that slow!! Apparently they hold onto it, wait until the VERY last moment, and then it gets into the mail system. Check the postmark on this; again, if it is dated June 1st then WHY would the postmark be June 17th? That's 17 days of time lost due to a sheet of paper sitting in an envelope or better yet, a BACKDATED letter is sent out on the 17th. Either which way, it's another tactic. Seems AETNA knows every little trick in the book to still be only 2 hairs within compliance with laws and regulations.

Nevertheless, being disabled myself and having to fight like we do JUST to try and make ends meet for another month is absolutely ridiculous. Seems that the first week of the month it's battling AETNA to cover prescriptions, the second week of the month it is battling prior authorizations, the third week is to re-send everything for weeks 1 & 2 again with even more "requested items", and week 4 is spent fighting with 50 different people over what has transpired over the last 3 weeks. This is a full-time job in and of itself!!

We have no choice but to fight, we have no choice but to basically "bow-down" and hope it works, and we have no choice but to go broke trying to get the coverage we pay for. What ticks me off the most is when people comment on these posts with condescending remarks such as "It is not an Automatic Right to get the benefits" and while true, it is not an Automatic FIGHT each time we attempt to utilize our benefits.

One thing gets their attention RIGHT away & a GUARANTEED response - threaten to cancel at the end of the policy or non-payment. If my mother wasn't locked in until open enrollment, I would not even be here writing a novel about how ridiculous this company is. As always, it's about profits, profits, and more profits and to hell with those of us suffering.

I apologize for the racing thoughts & jumping around of the subjects in my post however this is what happens when you SUFFER FROM BIPOLAR! Here's your "Evidence" AETNA!!
 8th of Aug, 2011 by   Unhappy in Minnesota 0 Votes
I have nothing but criticism for Aetna. They are the least customer oriented company I have ever dealt with in my entire life. The lack of compassion they demonstrate at Aetna is criminal. I am a paying customer of Aetna for 13+ years, yet when I needed the service I had been paying for most I am made to feel that my health is of no consequence. I am 6 months into a Short Term Disability Claim and have no idea if I am even one inch closer to Aetna meeting my needs. The process at Aetna is shrouded in mystery. I have yet to ever be in direct contact with anyone involved in any of the decisions about my health problems at Aetna. Aetna has shown no interest in how I am doing, let alone what this claim process does to my health. The utter lack of knowing what will ultimately happen to my claim and what my future will be is nothing short of maddening.

The person I have been forced to deal with at Aetna is never helpfull, she has given me incorrect information, she has given me misleading information, she has lied, and if I call her and leave a message it takes days for her to call back.
I would just hired an attorney 6 months ago if I had known what an ordeal this claim process would be for me and my family. The only income I have had has been from cashing in all my vacation and sick hours, which you can imagine falls very very short of what one needs at a minimum. I am lucky I still have a roof over my head.

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