[fatnoah]

> I and many friends have experienced Aetna routinely denying things that are explicitly covered by their plans and

My dad passed away from cancer over 20 years ago, and this was Aetna's plan even then. Each claim followed the exact same process of deny, approve but pay only pay a fraction, and then finally pay the correct amount. Literally every single claim. My mom built an automation in Excel to track the calls for each claim and to prompt her at the various time intervals required to follow up at each phase.

Personally, I experienced this went I went to the ER with acute abdominal pain and ended up having emergency surgery within a few hours. Naturally, Aetna tried to deny that my ER visit was an actual emergency. On the phone with the rep, I asked them if they new of any non-emergency situations where someone was able to have a surgery scheduled only 4 hours in advance. They agreed that it was an emergency and promptly paid $8k of the $16k bill. After another call several months later, they paid all but $800.