Aetna Medicare Provider Appeal Form. Or use our national fax number: Claim id number (s) reference number/authorization number.
Aetna Appeal Letter Sample Templates
Web you may mail your request to: Address, phone number and practice changes. Web (this information may be found on correspondence from aetna.) you may use this form to appeal multiple dates of service for the same member. Web file an appeal if your request is denied. Or use our national fax number: Claim id number (s) reference number/authorization number. Coordination of benefits (cob) employee assistance program (eap) medicaid disputes and appeals. You have 60 calendar days from the date of your denial to ask us for an appeal. Get a medicare advantage provider complaint and appeal form (pdf) get a non medicare advantage provider complaint and appeal form (pdf) to facilitate handling: Web reconsiderations can be submitted online, by phone or by mail/fax.
You may mail your request to: You must complete this form. You may mail your request to: To obtain a review, you’ll need to submit this form. Aetna medicare appeals po box 14067 lexington, ky 40512. Web (this information may be found on correspondence from aetna.) you may use this form to appeal multiple dates of service for the same member. Or use our national fax number: Appeals must be submitted by mail/fax, using the provider complaint and appeal form. An appeal is a formal way of asking us to review and change a coverage decision we made. Get a medicare advantage provider complaint and appeal form (pdf) get a non medicare advantage provider complaint and appeal form (pdf) to facilitate handling: You have 60 calendar days from the date of your denial to ask us for an appeal.
