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Aetna appeal form 2025

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The document outlines the process for providers to formally appeal denials of services by Aetna Better Health. It specifies the types of denials that can be appealed, such as denied inpatient days and services rendered without prior authorization. Providers must submit their appeals in writing within 60 days of notification, including necessary documentation like medical notes. The appeal can be sent via mail or fax to the Aetna Better Health Appeals Department.

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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.

What is the Aetna appeal filing limit?

You can file an appeal within 180 days of receiving a Notice of Action. The Appeals and Grievance Manager will send an acknowledgment letter within five business days. The letter will summarize the appeal and include instructions on how to: Revise the appeal within the time frame specified in the acknowledgment letter.

How do I request an appeal of an Aetna Medicare Advantage plan authorization denial?

National Medicare Dentist Line: Have a question? Call the National Medicare Dentist Line at 1-800-624-0756.

What is the limit called that payers allow to submit a claim or appeal?

In either case, if you do not agree with our decision, you can ask for a second review. You have 60 days from the date that you get the appeal decision letter to let us know. You can call Member Services at the phone number listed on your member ID card, or write to us.

What is the timely filing limit for Aetna appeal?

A timely filing limit is the maximum time a healthcare provider has to submit a claim after providing a service. The countdown begins on the date of service, not when the claim is processed internally. Late submissions often result in denials, and appeals for late claims are rarely successful.

What number is 1 800 624 0756?

In return, they cover the medical treatment you need when you need it. Nonetheless, insurance companies like Aetna may deny a claim. Sometimes its for a legitimate reason, but sometimes its not and understanding the difference can help you understand what a denied claim means for Aetna policyholders.

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How to appeal an Aetna insurance denial?

The appellant (the individual filing the appeal) has 120 days from the date of receipt of the initial claim determination to file a redetermination request. The notice of initial determination is presumed to be received 5 calendar days after the date of the notice, unless there is evidence to the contrary.

Aetna appeal form 2025

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Got questions?

What is the Aetna appeal filing limit?

How do I request an appeal of an Aetna Medicare Advantage plan authorization denial?

What is the limit called that payers allow to submit a claim or appeal?

What is the timely filing limit for Aetna appeal?

What number is 1 800 624 0756?

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How to appeal an Aetna insurance denial?

aetna reconsideration form

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