Po box 981106 el paso tx 79998

Health care providers can use the Aetna dispute and appeal process if they do not agree with a claim or utilization review decision.

Log in. Forgot username? Forgot password? Log in help. Register now for AetnaDental. Register now for Aetna's provider website on Availity. For your convenience, we have a single post office box for claims and specialty authorization submissions.

Po box 981106 el paso tx 79998

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Use our secure provider website to access electronic transactions and valuable resources to support your organization.

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Ask us in writing to reconsider our initial decision. You must:. In the case of a post-service claim, we have 30 days from the date we receive your request to:. You or your provider must send the information within 60 days of our request. We will then decide within 30 more days. If we do not receive the information within 60 days we will decide within 30 days of the date the information was due. We will base our decision on the information we already have.

Po box 981106 el paso tx 79998

Health care providers can use the Aetna dispute and appeal process if they do not agree with a claim or utilization review decision. Find dispute and appeal forms. Read our dispute process FAQs. Within 45 business days of receiving the request, depending on the matter in question, and if review by a specialty unit is needed. Within 60 business days of receiving the request. If additional information is needed, within 60 calendar days of receiving that information. See state exceptions to these timeframes. Use our secure provider website to access electronic transactions and valuable resources to support your organization.

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No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Register now for AetnaDental. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. Call the National Medicare Dentist Line at In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Education Site for your Patients. You are now leaving the Aetna Dental website. When billing, you must use the most appropriate code as of the effective date of the submission. Electronic claims. To reset or unlock your website registration, call Etech line : Reconsiderations: Formal reviews of claims reimbursements or coding decisions, or claims that require reprocessing. Applications are available at the American Medical Association Web site, www. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered i. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage.

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Dental Providers: Register now for AetnaDental. The Aetna Grievance and Appeals Unit also has one box for all states except California, which has a separate box. You are now being directed to the Give an Hour site Links to various non-Aetna sites are provided for your convenience only. Forgot username? Register now for AetnaDental. You can request more information 24 hours a day at www. Aetna response timeframe. Please select "Continue to ProVault to begin the contracting and credentialing process. Disputes and appeals. This information is neither an offer of coverage nor medical advice. Contact us.