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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

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Can you send secondary claims electronically?

Did you know that we can accept your secondary, or coordination of benefits (COB), claims electronically, too? In fact, we prefer that you send us your secondary claims electronically. When you send us the right information up front, we process your secondary claims faster.

How do I dispute a denied claim with Aetna?

To help us resolve the dispute, well need: A completed copy of the appropriate form. The reasons why you disagree with our decision. A copy of the denial letter or Explanation of Benefits letter. The original claim. Documents that support your position (for example, medical records and office notes)

What is the turnaround time for Aetna prior authorization?

Well also communicate with your provider throughout the process. Well come to a decision within 14 days and notify you and your doctor.

Does Aetna deny a lot of claims?

In comparison to the overall pool of services, denied claims were fairly rare. Less than two percent of Aetnas claims were denied (1.4 percent).

What happens when Aetna denies a claim?

While an internal appeal is the first line of action to get health insurance benefits after a denial, chances are that Aetna will still uphold their decision. If youve exhausted the appeals allowed under your plan, you have the option of requesting an external review with an independent physician.

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