Starmark from Aetna Complaint - Starmark good at finding rules under which they can deny your benefits
CLINTON, IOWA -- My company switched to Starmark couple months ago. We had a twin boys who were early by 11 weeks. SInce they were preemies they were to get Synages (costs about 2500 per shot)and the shots were to be given between Nov and April. These shots prevent bronchitis in premeeis. My old insurance company paid for the shots Nov through Jan and I am trying to get the authorization for shots of Feb and March 10 and I am still waiting for the authorization from the company and it's already April. Since last two months they keep pushing me and the doctors office around to complete some paper work. They have very complex system of meeting RX. They outsource their Prescriptions services to Wellpoint. Wellpoint outsources Pre-authorization services to another unit. Wellpoint also outsourced some of the special medicines to another company called Precision RX. To get an answer we have to call all the layers (at least 4) and then you get a vague answer saying that Pre-authorization was given but not used (by Precision RX) and Pre-authorization is valid only for 24 hours. I can't believe why a pre-authorization would be valid only for 24 hours. IF it's so then why not the Wellpoint Pre-authorizatin processor not inform the doctors office or the member. We have restarted the paperwork and Starmark says they haven't received the papers. My doctors office says they have proof of sending the Fax and the confirmations. Since Starmark insists that they have to get the papers again, we faxed them one more time. I am already on tag for shots for one month. Since Starmark is dragging its feet I may have to pay another month shots out of my pocket. Starmark SUCKS!!!