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Aetna Class Action UCR Settlement

Claim notices have recently been sent out regarding a recent class action settlement for which chiropractors are potentially in the class of physicians that can recover monies improperly underpaid by Aetna to out of network providers.

By way of background, class action lawsuits were filed against Aetna and Ingenix by Aetna subscribers, and several medical associations, including the parties settled in 2013 for up to $120 million, including $60 million in a general settlement fund from which class members will receive a maximum of $40 for each year that they were providers under an assignment of benefits. Another $60 million is available for “prove-up funds” that class members can opt for instead of the general fund. Subscribers who can prove they paid a balance over Aetna reimbursements that was equal to or greater than $750 will receive the lesser of either the balance or 3 to 5 percent of the amount allowed payable for that type of claim. Providers who can prove they received less than full payment for a balance can also make prove-up claims.

If you receive the claim notice and were an out of network provider that submitted claims to Aetna from June 3, 2003 through Aug. 30, 2013, you should submit either: i) (Option 1) a simplified notice of claim for the general settlement amount of $40 per year; or ii) (Option 2) a more detailed claim form with supporting documentation for “prove up funds” provided your underpaid claims for this time frame exceed $750.00. 

If you want to “opt in” and obtain funds from the settlement, your notice of claim must be postmarked no later than March 28, 2014, and should be mailed to:

Aetna UCR Litigation
c/o Berdon Claims Administration, LLC
PO Box 15000
Jericho, NY  11853

If you want to “opt out” and pursue your own private claim against Aetna, your notice of opt-out must be postmarked no later than Februay 26, 2014, and should be mailed to:

Aetna UCR Litigation – Exclusion
c/o Berdon Claims Administration, LLC
PO Box 15000
Jericho, NY  11853

For detailed information, FAQs, and online access to claim forms, please go to: http://aetnaucrsettlement.com/home.html

Jeffrey Randolph, Esq.
ANJC Legal Counsel

Triad purchased by MedSolutions

Triad, the managed care company that oversees chiropractic care for much of Aetna’s business in New Jersey, has been purchased by MedSolutions. 

Release from MedSolutions website