Aetna Loses the Fax

After my call being "released," I called Aetna back and navigated through another two minutes and fifty eight seconds of the same automated menus and questions then re-told my story to the most recent human.

I explained that, since Aetna is apparently impervious to anything sent via certified, return-receipt U.S. mail, I electronically scanned all the documents and created a 25-page PDF file which I was willing to e-mail to them in alternative.  As for the DVD video, I had converted it to Quicktime and Windows Media formats available for download from a web page I created for this sole purpose.  Is there an e-mail address to which I could send this latest rendition of the appeal?

AETNA:  I have no idea --  this is an appeal?

ME:  Yes.

AETNA:  Okay, let me see something because I don't have any -- I don't know that they take these as an e-mail.  Let me just check something for you.  Um -- [LONG DELAY]  Is this something you were appealing or the provider?

ME:  My wife and I.

AETNA:  Okay.  [LONGER DELAY]  Okay, let me check one thing for you.  May I place you on hold please?

ME:  Yes.

AETNA:  Thank you, one moment.

ME:  Thank you.

SEVEN MINUTES ON HOLD THEN:

AETNA: There is no way that the appeals area or myself can take an incoming PDF -- an incoming e-mail.  I'm sorry.  We're not allowed.  But I do have, unfortunately I do -- and fortunately, I do have a fax number that I could have you send that information to at the appeals area.

ME:  All right.  How do I confirm that you received it?

AETNA:  Um, I will -- I will be checking with the appeals area myself and I have a person that I can check with to see if she's actually picked it up off the fax machine.  I can do it that way.  Yeah.

ME:  Could you call me back to confirm receipt?

AETNA:  Sure.  I can do that.

Many of these documents were in color, and the relevant passages were highlighted with yellow highlighter.  I took the time to underline all those passages so they would be visible in a black and white fax.  Then I faxed it to the designated number.

The next day, this message was on our answering machine:

"You should get a letter next week from Aetna letting us know that we have your information."

One month later . . . no letter.

I called Aetna.  Automated menus.  Repeating the story to the eventual human.  More of my life wasted.  Etc.

ME:  It was a 25-page fax. 

AETNA:  Okay.

ME:  This was about a month ago. 

AETNA:  Okay.

ME:  And I asked the woman to call and confirm receipt, which she did.  She called the next day and confirmed that she received the 25-page fax and that we'd be receiving a letter in confirmation of receipt the following week.  That was a month ago and we haven't received a letter and there's no record of our appeal online.

AETNA:  Now you're saying that -- did you fax it directly to someone, or did you -- ?  What's the fax number that you faxed it to? 

At this juncture I could draw one of two conclusions:

One: Aetna's appeal process is intentionally designed to hinder and dissuade the appellate by creating so many hurdles to acknowledgement that clients eventually succumb to defeat by forfeiture. 

Two: Aetna's appeals department couldn't pour water from a boot with instructions on the heel.

Sophisticated individuals run insurance companies, so I suspect number one is the more accurate conclusion.

After further insistence, Aetna located the fax and, in three days, we had a letter of acknowledgement and a case number.  It's difficult to believe that, had I not made the above phone call, that letter would have ever been received.