What is the name of your state? California
Hi - My wife has dual coverage, one from her employer which is Kaiser HMO plan (recently added) and one from my employer which is Aetna PPO plan (Been with it for 2 years), she recently gave birth to a baby and we went to Aetna's covered hospital, only to realize towards our discharge that hospital mentioned Aetna may deny the claim and we have to pay out of pocket. Could you please let me know if hospital sends the claim first to HMO plan, then if I submit to Aetna PPO the EOB from HMO plan, will Aetna consider it, or outrightly denies it as primary denied it, though it doesn't make sense. I am in a situation where paying dual premiums and also going through this issue. Any help is much appreciated.
Hi - My wife has dual coverage, one from her employer which is Kaiser HMO plan (recently added) and one from my employer which is Aetna PPO plan (Been with it for 2 years), she recently gave birth to a baby and we went to Aetna's covered hospital, only to realize towards our discharge that hospital mentioned Aetna may deny the claim and we have to pay out of pocket. Could you please let me know if hospital sends the claim first to HMO plan, then if I submit to Aetna PPO the EOB from HMO plan, will Aetna consider it, or outrightly denies it as primary denied it, though it doesn't make sense. I am in a situation where paying dual premiums and also going through this issue. Any help is much appreciated.