Monday, January 28, 2008

Aetna, You Are Dumb

This isn't a Falling Down moment or anything like that, but it's as irritating as jalapeno juice in the eye. The Boy needs to be seen by a dentist. He doesn't have visible cavities, but I'm beyond sensitive about dental care. My parents didn't have it, so we went to the dentist when our teeth hurt. Having a tooth pulled every time you go to the dentist does not instill a healthy respect for the profession. Anyway, the books all tell me that this is around the age that a kid should head to ye olde dentist for his inaugural check-up.

My preference is for the Boy to be seen by a pediatric dentist. Call me crazy, but I think the Boy is more likely to enjoy the experience if the dentist has treated many, many kids. Yeah, so I went through Aetna's directory of pediatric dentists in my area, and called the one closest to me. As someone who served as an Human Resources liaison for an office, I'm well aware that you need to call a health care provider to double check that they (a) accept the insurance, and (b) are accepting new patients. Dr. Closest-to-Me's receptionist answered. Here's our exchange:

"Hi! I'm calling to make an appointment for my son. Does your office take Aetna DMO?"

"No, I'm sorry, we don't."

"Oh. Really? Dr. Closest-to-Me is listed in Aetna's directory."

"We used to take that insurance, but we don't anymore."

"Okay, thanks."

Now, I'm all about the free and fair exchange of information. So I e-mailed Aetna through their Contact Us form to let them know that this purveyor of pediatric dentistry doesn't take their insurance, and perhaps they should pull him from the directory. I wasn't snippy or anything -- these databases are a pain to maintain, so I figured I'd help where I could.

I got an e-mail back from them stating that since Dr. Closest-to-Me is technically a specialist (pediatric dentistry is special, apparently), so he can't be listed as a Primary Care Dentist (PCD). I was aware that I'd need to get a referral to be seen by that dentist, but my point was that the office no longer takes Aetna DMO, not that they wouldn't allow me to claim them as the Boy's PCD. So, I responded and thanked them for the info, but that the dentist's office pointedly told me that they do not take Aetna DMO at all, and that it has naught to do with the PCD vs. specialist shenanigans. Their response? Dr. Closest-to-Me can't be chosen as a PCD thing.

I'm leaving it at that. I like my head, and if I try to explain the situation again, I will be smacking it against a brick wall.

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