Comments on: Doctors v Aetna, What’s Happening in California? http://www.jdjournal.com/2012/07/04/doctors-v-aetna-whats-happening-in-california/ Legal Industry News Fri, 24 May 2013 17:30:27 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: John Stevens http://www.jdjournal.com/2012/07/04/doctors-v-aetna-whats-happening-in-california/comment-page-1/#comment-72136 John Stevens Wed, 04 Jul 2012 17:26:56 +0000 http://www.jdjournal.com/?p=45553#comment-72136 Does anyone find it odd that Aetna is comparing in-network contracted prices with out-of-network contracted prices? Something smells fishy about that. You would expect a comparison to made between out of network and out of network. Of course prices are going to be less for in-contract providers. "Cynthia Michener, further cited examples in support of the actions of Aetna, which if proved true, is quite revealing. For example, she cited doctors who charged $73,536 for a kidney stone fragmentation when Aetna’s average within network charge was around $7612. She further cited examples where a knee procedure which costs about $10,500 within the Aetna network was charged $37,572 by an out of network physician." Does anyone find it odd that Aetna is comparing in-network contracted prices with out-of-network contracted prices? Something smells fishy about that. You would expect a comparison to made between out of network and out of network. Of course prices are going to be less for in-contract providers.

“Cynthia Michener, further cited examples in support of the actions of Aetna, which if proved true, is quite revealing. For example, she cited doctors who charged $73,536 for a kidney stone fragmentation when Aetna’s average within network charge was around $7612. She further cited examples where a knee procedure which costs about $10,500 within the Aetna network was charged $37,572 by an out of network physician.”

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