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  • Aetna Provider Resolution Form 2013

Get Aetna Provider Resolution Form 2013-2025

Submission of provider disputes Providers can submit written disputes to Aetna Correspondence Unit P. O. Box 24019 Fresno CA 93779-4019 Written disputes can be submitted on the Provider Dispute Resolution Request Form Attachment A or in the form of a letter. Number each cover sheet. describe each provider dispute and reference the applicable numbered cover sheets. include A copy of the delegated payer s written determination/correspondence. the s.

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We require providers to submit claims within 180 days from the date of service unless otherwise specified within the provider contract.

You can file a grievance or appeal using our online grievance and appeal form. 1-855-772-9076 (TTY: 711). You can send a secure fax to Aetna® grievances and appeals at 959-888-4487. Your doctor can file a grievance or request an appeal on your behalf after you give them your written permission.

You can call or fill out a form with the insurance payer for an internal or external appeal. The Affordable Care Act requires that states set up an external review process for denied medical claims. Appeals can help resolve issues where your clients should have covered benefits but were denied.

You can fax your complaint or appeal to 1-877-223-4580. You can also email us with your complaint or appeal.

Timeframes for reconsiderations and appeals Dispute levelDoctor / provider submission timelineAetna response timeframeAppealsWithin 60 calendar days of the previous decision.*Within 60 business days of receiving the request. If additional information is needed, within 60 calendar days of receiving that information.1 more row

The Availity provider portal gives you the information, tools and resources you need to support the day-to-day needs of your patients and office.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232