PHOENIX — A month after Phoenix Children's Hospital and Aetna failed to renew a contract between them, some families are still looking for new doctors.
The contract between the insurance company and the hospital expired at the beginning of August. Since then, it's been a war of words between them.
Because the contract expired, PCH doctors are no longer considered "in-network." Patients could keep seeing them, but they'll pay much higher "out of network" prices.
Andy Sessions' daughter Paisley has been to PCH three times in her first two years of life. Sessions said Paisley has a chronic respiratory condition that flares up when she gets so much as a cold.
"It can cause irritation in her lungs and give her difficulty breathing," Sessions said.
Now, however, Sessions is looking for a new doctor. And, being a new dad, he's not sure where to start.
"So we can't see the same doctors that know what's going on and have taken care of her," he said. "It's just a whole other thought process that shouldn't be involved in taking care of your child.”
Sessions' mother-in-law, Dena Baldwin, has two other kids who see specialists through PCH. Both are teenagers and have a long history with their doctors.
Baldwin's son has a chronic eye condition, her daughter has a digestive condition.
“We've found these specialists, we've been treated by the specialist and now we're told you can no longer use the specialist," Baldwin said.
And the entire situation is out of their control. The only thing they can do is try to start over with new doctors, transferring medical records and waiting for appointments. Baldwin said she's found new doctors for her teenagers, but the wait for a first appointment is months long.
When asked for an update on negotiations, Phoenix Children's Hospital sent this statement:
“Phoenix Children’s is no longer an in-network provider with Aetna as of August 7, 2023. While Aetna has cited it will honor in-network rates, Aetna has informed Phoenix Children’s that only certain patients approved by Aetna will be treated as in-network for a short period of time, creating significant confusion for families.
Our clinicians are working hard to help patient families seek in-network access and continuity of care benefits with our many specialists, surgeons and providers, but Aetna is delaying many of these in-network patient access requests. We are committed to fighting for our patients and holding Aetna accountable and we encourage patient families to contact Aetna today for answers regarding their benefits.”
12News reached out to Aetna but did not immediately hear back.
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