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The document outlines the process for health care providers in New Jersey to appeal claims determinations made by Aetna. It specifies the conditions under which appeals can be submitted, including reasons for denial and payment disputes. The document also provides instructions on completing the appeal application, required documentation, and important notes regarding eligibility for external arbitration.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out Section A: Provider Information. Enter your name, group (if applicable), and contact details. Ensure your signature is complete and legible, and remember to date the form.
Proceed to Section B: Patient Information. Fill in the patient's name, title, contact address, phone number, and insurance ID.
In Section C: Claim Information, provide the claim number, date of service, and authorization number if available. Indicate how you filed the claim by checking the appropriate method.
Complete Section D: Reason for Appeal. Check all relevant reasons for your appeal and provide specific billing codes where necessary.
Attach any required documents as specified in the instructions. Ensure all attachments are copies only.

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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.

Where to mail Aetna appeals?

The first thing you may need to do if Aetna has denied your claim is to appeal. This is where you request, in writing, for the insurance carrier to take another look at your case you send over your policy details and any and all medical information regarding your situation, and ask for a second opinion.

How long does an appeal take for Aetna?

Submitting your claims electronically is quick, convenient and easy. Choose the option that works best for you.

Where to send Aetna appeals?

lf we deny a claim and you do not agree, you can ask for a review. This is called an appeal. There are two ways to do this: Call Member Services at the phone number on your member ID card.

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