Reminder: March 28 deadline for class action lawsuit settlement claims submission

Follow our step-by-step guidance for submitting claims.

Friday, March 28, 2014, is the postmark deadline for eligible psychologists to submit claims to the Aetna Ingenix settlement. The Jan. 30, 2014, issue of our PracticeUpdate e-newsletter described who is eligible and provided step-by-step instructions for members submitting claims

This lawsuit in federal court in New Jersey alleged that Aetna used the faulty Ingenix database that caused the company to underpay claims for services delivered by out-of-network providers. The APA Practice Organization (APAPO) has been collaborating actively with the New Jersey Psychological Association, a named plaintiff in this lawsuit, since 2009.

In December 2012, Aetna Inc. agreed to a proposed $120 million settlement of the class action lawsuit by psychologists, other health care providers and patients. The $120 million settlement amount includes a $60 million general fund for all class members to file claims under Option 1 without detailed supporting documentation, and a $20 million fund for providers who provide more detailed documentation under Option 2. 

We expect that psychologists who submit Option 1 claims will recover as much as $400 if they can attest that they provided covered out-of-network services to Aetna subscribers that resulted in partially allowed claims (meaning Aetna paid an allowed amount, but less than what the psychologist billed) for each of the 11 years of the class period from June 2003 through August 2013. 

Submitting an Option 1 claim requires simply completing a few quick steps. Further details are provided in Section 3(a) of the Jan. 30 PracticeUpdate article.

The court gave its preliminary approval to the settlement last August. We expect the court to give the settlement final approval at or after a hearing on March 14. We do not recommend that eligible members wait for final approval before preparing their claims.

This class action lawsuit settlement is the latest in a series of legal actions against abusive managed care practices with which APAPO has been involved. This is the fourth time that APAPO has guided members through submitting claims in an insurance class action settlement. 

If you have further questions

The settlement administrator’s website has more than 60 FAQs which answer many questions psychologists are likely to have. 

APAPO has reached out to the settlement administrators and the class action lawyers for further information on submitting Option 1 claims on behalf of a group practice. FAQ 55 indicates that a group practice may either file a claim on behalf of all members, or each member can file his or her own claim. But it is not clear whether the group’s claim would be multiplied by the number of eligible providers in the group, and if so, how the settlement administrator would determine how many eligible providers there are in the group.

If APA Practice Organization members have other questions not answered by the Jan. 30 PracticeUpdate article or the settlement administrator’s FAQs, they may contact the Office of Legal & Regulatory Affairs at (800) 374-2723, ext. 5886 or by email.

Alternatively, you can contact the settlement administrator at: 


Mail
 
Aetna UCR Litigation
c/o Berdon Claims Administration LLC
P.O. Box 15000
Jericho, NY 11853-0001 
Email

Phone 
(800) 600-3079

Fax 
(516) 393-0031