Just faced this situation this week....we are being billed for a radiology reading done at an in-network facility but the reading cost has been denied. Aetna has always caught it before and sent a letter stating that we were not responsible. The local hospital tries it all the time..billing for out of network docs or procedures that should be included in the agreed upon fee.

I always handle the insurance stuff..make the phone calls and such. I have talked with Aetna over the course of Bill's illness several times but when I called this week, I was informed that Bill's account was restricted and that he requested it. WHAT????? Believe me, he would in no way want to restrict me from handling insurance matters...he is allergic to it! I was so aggravated..needing to get the billing matter handled and they wouldn't talk to me. We have to now wait for the form (that we have already signed once) to get here..have Bill sign it and wait for them to process it. GRRRRRRR!