This decision was decided in Feb 2008 and we just hear about it now. This decision has had a ripple effect beyond what meets the eye!!Aetna creates coverage hailstorm
A Cumberland County radiology practice is crying foul over health insurer Aetna's decision to terminate its contract.e Center for Diagnostic Imaging (CDI), which was established in 2001 and opened its first office in Vineland in 2002, learned in late February it would be removed from the insurance company's coverage network effective Sept. 1.CDI physicians claim Aetna terminated the contract "without cause." They have asked Aetna whether the decision came about as a result of concerns over billing problems or quality of service.
"TheyÕre telling us Ôno,Õ" Dr. Satish Shah said on Monday. "Then why are we not still in? ... It does not make sense."
About 10 to 12 percent of CDI's patients are covered by Aetna, according to Shah.
Shah and the other CDI physicians believe Aetna's decision to remove the practice from its network was somehow influenced by the Connecticut-based health insurance company's then-ongoing negotiations with South Jersey Healthcare (SJH).
SJH announced last week that it and Aetna had reached agreement on a new contract. The hospital system said in a press release issued Thursday that the deal includes a "preferred" arrangement for radiology services in the area, but clarified on Friday by calling it an "expanded" arrangement.
Both Aetna and SJH denied the allegation that their three-year agreement hinged on CDI being eliminated from the coverage network.
"Our discussions with Aetna did not include any demands or requests with regard to CDI," SJH spokesman Paul Simon said.
It is "entirely coincidental" that SJH's new contract begins Sept. 1 Ñ the same day CDI's expires Aetna spokeswoman Susan Millerick said.
CDI alleges that SJH and Aetna brokered a deal that will effectively allow SJH to monopolize imaging services in Cumberland County.
"You talk to Aetna, but they don't want to listen," Shah said. "There must be some deal."
"SJH obviously wants to control all health care in the county and eliminate free choice in outpatient health care instead of concentrating on providing hospital-based care," CDI Dr. Steven Rothfarb said in a statement.
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