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Life Health > Long-Term Care Planning

Aetna Adopts Physician Relations Principles

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A managed care company says it wants to continue to maintain strong bonds with the doctors in its provider networks.

Aetna Inc., Hartford, is marking the end of a “physicians settlement agreement” period by issuing “guiding principles” that call for the company to continue to do voluntarily many of the things it has been doing in connection with the settlement agreement.

Aetna accepted the settlement agreement to resolve a lawsuit brought against it by doctors who accused it and other managed care companies of using unfair tactics to confuse them and hold down their reimbursement rates.

In the new guiding principles document, Aetna says it will take steps such as permitting doctors to get out of its networks within 90 days of sending termination notices.

The company will permit doctors to submit claims up to 120 days following provision of service, and it will continue to make fee schedules available for participating providers 90 days prior to the effective date of any change, the company says.

Aetna will not use “gag rules,” or require doctors in one plan network to participate in all Aetna plan networks, and it will continue to seek advice from doctors through a physician advisory board, the company says.

Aetna notes that it has created a similar set of principles for working with dentists.


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