Aetna says it paid millions in error

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HARTFORD, Conn. (AP) -- Aetna has told investors that it has been paying some claims twice and paying medical bills for people who are no longer members.

The announcement was the latest in a series of financial problems at the company, which has struggled with high medical costs, lagging profits and controversy over its policies toward patients.

``We are over-paying very substantially,'' Aetna Chief Executive Dr. John W. Rowe said at the annual investor conference in New York. ``We are going to stop over-paying.''

Rowe said Aetna has not disclosed the amount it has overpaid, but said he believes it is millions of dollars.

Aetna has already said it has underpriced its health plans and attracted more than its share of higher-risk members. The company plans to remedy that problem by eliminating unprofitable business and raising prices.

Aetna will try to recover the money paid in error as it has in the past, company spokesman Fred Laberge said. He said the company will be taking a more ``disciplined'' approach toward identifying and preventing overpayments.

Rowe said about 11 percent of the claims Aetna receives need further review or additional information before they can be processed.

Of those, 56 percent are duplicate claims, which occur when health-care providers use more than one method -- mail, e-mail, fax -- to send copies of a claim to an insurer.

Rowe also said Aetna has paid claims for people who aren't covered by the company anymore due to communication lapses with its claims management organization.

The Mercury News

-- Anonymous, June 10, 2001


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