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Practice Management Alert

Payer Updates:

Aetna Announces New Policy of Payment Refusal for 'Never Events'

Published on Tue Sep 22, 2009

Make sure you know the extra steps you need to take as well. Many payers are jumping on the "never event" bandwagon, and Aetna is the most recent. The payer announced recently that it will no longer pay you for any care related to 28 preventable medical errors, such as wrong surgeries, wrong person surgeries, or surgeries on the wrong side of the body. If you practice is dealing with a never event, Aetna is also requiring you to take the following steps: • Alert Aetna and at least one agency concerned with patient safety such as the Joint Commission or your state's medical error reporting programs. • Analyze the problem and find ways to improve patient care and processes. • Communicate with the patient or patient's family about the event. "We're not simply asking health care providers to waive payment for medical errors; we're asking them to engage with [...]
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