Aetna Self-Insured Low Pay

This is a 2014 case wherein the provider was grossly under-reimbursed.  The billed charges were $28,500.00 and the insurance company paid $2,533.39.  The provider filed appeals, but did not receive any additional payments.  The file was then forwarded to CH Revenue Management Solutions at which point the appeals process had expired. Nevertheless, the group filed member appeals and ultimately received an additional payment for the provider in the amount of $15,977.21.

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