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Aetna Establishes Principles to Promote Ongoing Strengthened Physician Relations.


Principles Define Standards for High-Integrity Interactions; Company Seeks Collaborative Solutions to Health Care Quality and Cost Issues

HARTFORD, Conn. -- Aetna (NYSE NYSE

See: New York Stock Exchange
:AET AET Aetna, Inc.
AET After Extra Time
AET Actual Evapotranspiration
AET Alliance for Environmental Technology
AET Alpha-Ethyltryptamine
AET Applied Extrusion Technologies, Inc.
) today unveiled Guiding Principles for Physician Relations that formally define the company's continued commitment to building the best possible relationships with the medical community and to working collaboratively to improve the quality of health care. The Principles identify specific behaviors and business actions that govern Aetna in its interactions with health care professionals.

The Principles coincide with the June 2, 2008 expiration EXPIRATION. Cessation; end. As, the expiration of, a lease, of a contract, or statute.
     2. In general, the expiration of a contract puts an end to all the engagements of the parties, except to those which arise from the non- fulfillment of obligations created
 of the Physicians Settlement Agreement with Aetna and are relevant at a time when concerns about health care access, quality and affordability are top of mind for most Americans.

"True health care reform will come from public, private and government sectors addressing issues together. We have worked hard to establish a level of trust and respect with health care professionals. And we want to build on that trust and continue to be a high-integrity business partner with the medical community, even when our settlement agreement expires next month," said Troyen Brennan, M.D., Aetna's chief medical officer. "These Guiding Principles clearly demonstrate, in writing, that we are serious about making it even easier to do business with us and moving forward with the medical community to ensure patients have the highest quality, safest and most cost-effective care."

"Aetna has made significant progress in its relationships with physicians by changing past practices that were not consistently transparent and respectful re·spect·ful  
adj.
Showing or marked by proper respect.



re·spectful·ly adv.
 of providers," said Robert W. Seligson, executive vice president and CEO (1) (Chief Executive Officer) The highest individual in command of an organization. Typically the president of the company, the CEO reports to the Chairman of the Board.  of the North Carolina North Carolina, state in the SE United States. It is bordered by the Atlantic Ocean (E), South Carolina and Georgia (S), Tennessee (W), and Virginia (N). Facts and Figures


Area, 52,586 sq mi (136,198 sq km). Pop.
 Medical Society, and president of the Physicians Advocacy Institute (PAI PAI plasminogen activator inhibitor.
PAI Plasminogen activator inhibitor, see there
), a nationwide not-for-profit organization that advances the interests of the physician community. "Much of that success has resulted from the company's constructive dialogue with physicians and putting its words into action. We obviously will not always agree. However, Aetna's commitment to remain true to the spirit of the settlement agreement ensures our conversations will be candid can·did  
adj.
1. Free from prejudice; impartial.

2. Characterized by openness and sincerity of expression; unreservedly straightforward: In private, I gave them my candid opinion.
 and productive and this will set the stage for quicker resolution of any future issues. Aetna's voluntary continuation of the business practices from the settlement is a model for other health plans."

Creating guiding principles reflects Aetna's historically proactive approach to working cooperatively with the medical community. Aetna was the first health plan to settle the class action lawsuit class action lawsuit

A lawsuit in which one party or a limited number of parties sue on behalf of a larger group to which the parties belong. For example, investors may bring a class action lawsuit against a brokerage firm that has actively promoted a tax
 with physicians and voluntarily extended its settlement agreement one year past the original end date. The company also transferred funds ahead of schedule to the Physicians Foundation for Health Systems Excellence, created as a result of the physicians' settlement, to expedite ex·pe·dite  
tr.v. ex·pe·dit·ed, ex·pe·dit·ing, ex·pe·dites
1. To speed up the progress of; accelerate.

2.
 the Foundation's mission to improve health care quality. In addition, the company was the first health plan to make its clinical policy bulletins available online.

All of the changes Aetna made as part of the settlement agreement are embedded Inserted into. See embedded system.  in the company's business model and are consistent with the way the company wants to continue working with physicians. The Principles reinforce those changes and include commitments such as:

Aetna will work to make it easier for physicians to do business with us.

* We will allow physicians to terminate from our network 90 days after we receive their notice, with no need to show cause.

* We will continue to allow submission of claims up to 120 days following provision of service.

Aetna will continue to make our business processes as transparent as possible.

* We will continue to make fee schedules available for participating providers 90 days prior to the effective date of any change.

* We will provide transparent information on our claim check logic and continue to work with providers to ensure consistency in bundling and other claim policies.

* We will continue to disclose all precertification requirements on a timely basis.

* We will not use all-product or "gag" clauses in contracts, but will continue to use the new definition of "Medical Necessity."

Aetna also has committed to strengthening a variety of forums through which the company can have important ongoing dialogue with the medical community. As examples:

* The company will continue working with the PAI to help physicians better understand how various health plan initiatives, like pay for performance and physician ratings, impact the day-to-day care that physicians provide their patients. Aetna is discussing with the PAI the voluntary establishment of new mechanisms to address physician questions about company policies.

* Aetna also will maintain the Physician Advisory Board, a distinguished group of independent practicing physicians who provide advice on issues of importance to doctors and make recommendations as appropriate with regard to Aetna's business practices and policies.

Since the Settlement Agreement, Aetna has simplified business transactions with physicians, increased transparency of policies and processes, and worked with the medical community to encourage adherence to evidence-based guidelines guidelines,
n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks.
 in medicine, among other improvements. Business practice changes that support the exchange of more timely, consistent and transparent information have had the greatest impact on the company's relationships with doctors.

Aetna also has created a similar set of guiding principles for working with the dental community. Aetna's settlement agreement with dentists ended in April.

To see the Principles, please visit Guiding Principles for Physician Relations - www.aetna.com/provider/medical/join_med/advantages_med/principles.html and Guiding Principles for Dentist dentist /den·tist/ (den´tist) a person with a degree in dentistry and authorized to practice dentistry.

den·tist
n.
A person who is trained and licensed to practice dentistry.
 Relations - https://www.aetnadental.com/AD/ihtAD/r.WSIHW000/st.35410/t.75665.html.

About Aetna

Aetna is one of the nation's leading diversified diversified (di·verˑ·s  health care benefits companies, serving approximately 37.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health Behavioral health was first used in the 1980's to name the combination of the fields mental health and substance abuse. As an example, an organization serving both mental health and substance abuse clients might refer to its practice as behavioral health or , group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups employer group Association of employers Managed care An entity with a current group benefits agreement in effect with a health plan to provide covered health care services to its employee-subscribers and eligible dependents. , individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. www.aetna.com.
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Publication:Business Wire
Date:May 28, 2008
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