Get Aetna Gr-68976-1 2016-2025

Filing the Aetna GR-68976-1 form for reimbursement can seem daunting, but with clear guidance, you can navigate the process smoothly. This comprehensive guide will walk you through each section of the form, ensuring that you provide all necessary information correctly.

Follow the steps to complete your reimbursement request seamlessly.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Enter the student name in the designated field. This is the name of the individual requesting reimbursement.
3. Provide the Aetna ID number as indicated on your Aetna medical ID card. This is essential for processing your request.
4. If applicable, enter the name of the subscriber’s spouse or domestic partner in the designated field. This is only necessary if the reimbursement request is for them.
5. List the name(s) of the exercise facility or facilities where the membership was held.
6. Fill in the address of each exercise facility provided in the previous step.
7. Include the names of exercise facility representatives involved in your membership or visits.
8. Provide the phone numbers for each exercise facility representative listed.
9. Enter the email address of each exercise facility representative.
10. Indicate the total cost of the membership for the six-month period being claimed.
11. Attach exercise facility documentation. This may include membership details and proof of payment.
12. Have the exercise facility representative sign the documentation to authenticate your membership.
13. Specify the date(s) of visit during the six-month period. All visits should total at least 50 for reimbursement.
14. Confirm that you have met the program requirements including being an active member and completing the necessary number of visits.
15. Review all entered information for accuracy before submission.
16. Once complete, save any changes you've made to the document.
17. Download a copy of the completed form for your records.
18. Consider printing the form for a hard copy if necessary.
19. Share the completed form with relevant representatives if required.

Take the first step towards your reimbursement by completing the Aetna GR-68976-1 form online today!