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Patient Advocate Foundation, Aetna Offer Program To Help Members Navigate The Most Complex Access And Coverage Issues

Patient Advocate Foundation (PAF) and Aetna ( NYSE: AET) announced today a joint effort to help members navigate the sometimes unavoidable complexities of the health care system. Personalized information and resources offered through the Aetna Clinical Appeals Care Line help members with complicated health care cases and, most importantly, get them needed care.

The Care Line is part of Aetna’s commitment to give members support, when they need it, to make confident choices and live a healthier life.

“We are proud that nearly 92 percent of our group medical members are satisfied with the service they get from Aetna. But sometimes they need financial support and assistance to supplement what their health plan covers,” said James D. Cross, M.D., Aetna’s head of National Medical Policy and Operations. “We are glad to offer a resource that helps members maximize their coverage, connect to community support and make informed health care decisions.”

Aetna members who may benefit from the services are referred as part of Aetna’s appeals process. Members can access PAF through the Care Line. This dedicated phone line is staffed by professional case managers from PAF’s Mission Delivery team. They use their knowledge of coverage issues, health care resources and clinical experience to independently find solutions when members face challenges. Their patient-focused approach assists members with:

  • Research and resolution of claims pending coverage
  • Screening and enrollment for Medicare, Medicaid and Disability
  • Referrals to local, state or federal resources

“We are pleased to help Aetna members when potential barriers to the health care system can’t be overcome through a health plan alone,” said Beth Patterson, PAF’s president of Mission Delivery.

Aetna and PAF began working together last year. Their relationship has benefitted members by making health care easier to understand, access and navigate.

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