Get Provider Claim Resubmission /reconsideration Form Mail To: Aetna Better Health Of Nebraska
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How to fill out the Provider Claim Resubmission /Reconsideration Form Mail To: Aetna Better Health Of Nebraska online
Filling out the Provider Claim Resubmission /Reconsideration Form is crucial for healthcare providers seeking to correct and resubmit claims efficiently. This guide will walk you through each component of the form to ensure you provide all necessary information accurately.
Follow the steps to complete the form successfully.
- Press the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
- Begin by entering your contact information in the 'From:' section, which includes your name and phone number.
- Indicate whether you are submitting a corrected claim or a reconsideration by filling in the relevant section.
- Fill in the 'Required Information' section with the member's name, date(s) of service, amount billed, member ID number, remittance advice date, and amount paid.
- Enter the claim number(s) associated with the submission, ensuring accuracy to avoid processing delays.
- Use the space provided for any additional necessary information, including notes or explanations that could support your claim.
- Review your form for completeness and accuracy, then save changes to your document.
- Finally, download, print, or share the completed form as required for submission.
Complete the Provider Claim Resubmission /Reconsideration Form online to ensure a smooth and efficient claims process.
Call Member Services at 1-800-279-1878 (TTY: 711) and choose the crisis option. We're here for you 24 hours a day, 7 days a week.
Fill Provider Claim Resubmission /Reconsideration Form Mail To: Aetna Better Health Of Nebraska
As a health care provider, you may not agree with a claim or utilization review decision. This page explains how to dispute or appeal a decision. Print a non-Medicare complaint form. If you have a non-Medicare plan, you can print and complete a form to mail or fax to us. A Request for Reconsideration (Level I) is a communication from the provider about a disagreement with the manner in which a claim was processed. Aetna's 180-day dispute filing standard will apply. The exceptions below apply to requests regarding members covered under fully insured plans only.
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