Aetna aor form 2025

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The document is a form from the Department of Health and Human Services, specifically for appointing a representative to act on behalf of a Medicare beneficiary in connection with claims or appeals under the Social Security Act. It includes sections for the appointment, acceptance, waiver of fees, and guidelines for charging fees for representation. The form ensures that representatives are qualified and that any fees charged are reasonable and approved by the Secretary.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (81 Votes)
2015	4.4 Satisfied (160 Votes)
2012	4.3 Satisfied (70 Votes)
2011	4.2 Satisfied (53 Votes)
2010	4.7 Satisfied (65 Votes)
2005	4.4 Satisfied (64 Votes)

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Got questions?

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 are the four types of Medicaid?

There are four types of Medicaid delivery systems: State-operated fee-for-service (FFS) Primary care case management (PCCM) Comprehensive risk-based managed care (MCO model) Limited-benefit plans.

Is Aetna Medicaid the same as Aetna?

Aetna and Medicaid Our plans go by different names in different states, but they all offer the same high-quality care.

What is an AOR form Humana?

Appointment of representative form for appeals and grievances. If you are filing an appeal or grievance on behalf of a member, you need an Appointment of Representative (AOR) form or other appropriate legal documentation on file with Humana so that you are authorized to work with Humana on his or her behalf.

What is the corrected claim form for Aetna?

The purpose of the Aetna corrected claim form is to submit necessary corrections to a previously submitted claim for healthcare services. This form allows healthcare providers to update any errors or missing information on the original claim, such as incorrect procedure codes, billing codes, or patient data.

Does Aetna have Medicare and Medicaid?

Keep your Medicaid and Medicare and get even more We help you stay healthy and meet your day-to-day needs with our Dual Special Needs Plans (D-SNP). The D-SNP works alongside your Medicaid benefits. And you may be able to keep your existing doctors and providers.

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Key Facts About the Appointment of Representative Form

Purpose of the Form

Sections of the Form

Fee Waiver Conditions

Approval Requirement for Fees

Conflict of Interest Regulations

Submission Instructions

OMB Control Number

Purpose of the Form

The form is used to appoint a representative to act on behalf of a Medicare beneficiary in connection with claims or appeals under the Social Security Act.

Sections of the Form

The form consists of several sections including appointment details, acceptance by the representative, waiver of fees, and waiver of payment for items or services.

Fee Waiver Conditions

Representatives may waive their right to charge fees for representation, especially if they are providers or suppliers who have furnished items or services.

Approval Requirement for Fees

Any attorney or representative wishing to charge a fee must obtain approval from the Department of Health and Human Services (HHS) according to specific regulations.

Conflict of Interest Regulations

Certain individuals with conflicts of interest are prohibited from acting as representatives before HHS, ensuring integrity in the representation process.

Submission Instructions

The completed form should be sent to the same location where an appeal or grievance is being filed, ensuring proper processing.

OMB Control Number

The form has an OMB control number (0938-0950), which indicates compliance with the Paperwork Reduction Act and ensures that responses are voluntary unless specified otherwise.

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What is Florida Medicaid called?

Remember, Aetna and Coventry are the same company, so you and your patients may see either name or logo on the communications we send to you. Were always working to improve your experience. So if you have any questions or concerns, please call us. You can reach us at the number on your patients ID cards.

Aetna aor form 2025

Here's how it works

The fastest way to redact Aetna aor form online

See more aetna aor form versions

Complete this form in 5 minutes or less

Got questions?

What are the four types of Medicaid?

Is Aetna Medicaid the same as Aetna?

What is an AOR form Humana?

What is the corrected claim form for Aetna?

Does Aetna have Medicare and Medicaid?

Key Facts About the Appointment of Representative Form

Purpose of the Form

Sections of the Form

Fee Waiver Conditions

Approval Requirement for Fees

Conflict of Interest Regulations

Submission Instructions

OMB Control Number

Purpose of the Form

Sections of the Form

Fee Waiver Conditions

Approval Requirement for Fees

Conflict of Interest Regulations

Submission Instructions

OMB Control Number

Complete this form in 5 minutes or less

People also ask

What is Florida Medicaid called?

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