Availity . Dental Benefits RequestMail to: Aetna Dental PO Box 14094 Lexington, KY 40512-4094 TO BE COMPLETED BY EMPLOYEE - USE BLACK INK ONLY 1. Once you complete the EFT form, you can submit it by fax at 1-855-596-8401. Follow Aetna. Patient ID or subscriber's Social Security number Patient date of birth Date of service range Provider fax number (if a fax back is needed) For inquiries submitted online, please provide: Provider billing tax identification number (TIN) and NPI Patient ID or subscriber's Social Security number Subscriber first and last name Open the document in the online editing tool. 2. BE SURE TO KEEP COPIES OF CLAIMS SUBMITTED FOR YOUR FILES MAIL CLAIMS TO: AETNA P.O. Call 800.821.6136 for help with your medical plan, or call 877.434.2336 for help with your dental plan. Member Services - PPO, Dental, Life,Indemnity, AD&D: ID cards, Claims & Eligibility Questions,Precertification/Claim Assistance . To reach an Informed Health Line Nurse, please call 1-800-556-1555 (TTY: 711). Amount charged for each procedure, including . After you submit your completed claim form, you will receive a notification by e-mail to confirm that it has been submitted successfully. Mail: Pennsylvania Department of Health. Complete name and address of the provider. Lexington, KY 40512-4094. P.O. Aetna HMO Plans (California) 888-702-3862 (Benefit Questions or Claim Inquiries) When you have all the information necessary, mail your claim to the Aetna office shown on the top of this form. Fax: 717-214-6690. PO Box 14094. Mail paper claims to: Aetna Better Health of Florida P.O. Call Customer Care on 1-800-307-4830. Box 359. You can get an EFT form here or on our Provider Portal. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and Electronic Remittance Advice. Phone: (866) 272-6630 Fax: (855) 482-7876 Email**: ClaimsMemberInquiries@aetna.com (insert name of underwriting company) P.O. M M D D Y Y Y Y Male . Oklahoma form numbers for discount programs: GR-96402-04 6-13 The Aetna Grievance and Appeals Unit also has one box for all states except California, which has a separate box. Fast, accurate and secure transactions. Dental plans and vision benefits are insured by Aetna Life Insurance Company (Aetna) 151 Farmington Avenue Hartford, CT 06156. dental service, eyewear, hearing aid, vaccine or fitness reimbursement you paid a doctor, healthcare . Please complete this cover sheet and FAX with your documentation to be processed. . It is important to keep your information current as it could impact the timely sharing of communications and claim payments. address and complete phone number of dentist. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare plans, including individual and family plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Dental for non-Medicare plans - 1-800-451-7715 (TTY: 711) Allow 10-15 business days for processing. Date of service for each procedure. Dual Eligible Special Needs Plan (D-SNP) 1-866-409-1221 ${tty}. Also, SKYGEN's provider portal supports secondary and tertiary dental claims. MHBP Consumer Option Hotline 800-694-9901. . How to make a claim for treatment under a direct billing facility. Electronic Submissions: Through SKYGEN's Provider Portal: https: . Contact us by phone The Provider Service Center helps with benefits, claims and many other questions. Vision. If you need to fax us, our toll-free fax number is (959) 888-4124. Box 14770 Lexington, KY 40512-4770 Claims Hours: M-F 7:00 AM-5:00 PM CT Make check payable to the appropriate c/o Bank of America underwriting company Reference policyholder name and policy number on all checks and corre . aetnavitalsavings.com . Visit Customer Care Contact Form. 3. Employee's Birthdate (MM/DD/YYYY) 6. London, KY 40742 Pennsylvania Institutional Special Needs Plan (PA I-SNP) Read the guidelines to discover which data you must give. You'll pay for your dental care up front when you see a dentist, and then submit your receipts to Aetna for reimbursement. Call our hotline at 1-800-338-6361 (TTY: 711) or email us at AetnaSIU@aetna.com. If your request is incomplete, we will communicate with you on your monthly Explanation of Benefits statement. Aetna member ID number on each receipt and bill. Log in at www.aetnainternational.com and click 'Claims Center' Fax it Outside the US: +1 800 475 8751 (via AT&T + access code) . Aetna Federal Plans Questions? Use this comments section to discuss problems you have had with Aetna, or how they have handled your . MHBP Dental and Vision Plan Information 800-254-0227 (Monday through Friday, 8 a.m. to 6 p.m. Eastern time) 24/7 Nurse Advice Line 1-800-556-1555. Select the fillable fields and add the necessary information. Watch Aetna Comments. "With a direct member reimbursement allowance, you're given a set amount of money to spend each year on dental care." You can see any licensed dental provider in the U.S. Phone: 1-888-772-9682. Access information quickly For 24-hour access to your patient's health information, log in to your account. Copy, scan and upload your supporting documents, including itemized bills, original receipts. . Click "submit claim" to complete the process. All materials submitted will be retained by us and cannot be returned to you. If you'd like more information about BannerlAetna or have a question, just call our toll-free number at 1-800-381-6789. Complete Aetna Dental Fillable Claim Form online with US Legal Forms. This is sometimes referred to by its HIPAA transaction number, 835. Aetna Claim Address And Aetna Provider Phone Number: Aetna Medicare Providers Claim Address and Phone Number Aetna HMO and PPO Plans Phone number Statewise Aetna Plan Phone number and Claim Address Aetna claim address and Aetna phone numbers are very important to handling denials, AR follow-up and claim submission. GR-68559-1 (10-14) Cover sheet for Aetna member FAX submission . As an Aetna Medicare member, you have the right to: Ask for coverage of a medical service or prescription drug. Milwaukee, WI 53201 . Click "Claims Center," then "Submit claims". Box 982965 El Paso, TX 79998-2965 * All claims and specialist authorizations Aetna Dental P.O. Address: Member Services and DSNP Customer Service. Fax to: 1-859-455-8650. File an appeal if your request is denied. Gender . . Some of the benefits of setting up an EFT include: Improved payment consistency. Complete your claim online. Complete description for each procedure. Dental QPLs are available to meet with PA dental practices to discuss the program in detail. c) Show your membership card. Persons with speech or hearing impairments can contact us at 800.735.2966. Phone 847-615-1500 Mail Trustmark 400 N. Field Drive Lake Forest, IL 60045 Contact Form Media Bob Gosman Communications Email Contact Via Email If you choose to communicate with us by email, you should be aware that the security of incoming Internet email is not secure. Federal Employees Health Benefits Plans - Aetna - Contact Us. This is now an automated process. Our address is: Aetna Better Health of Florida 8200 NW 41st Street, Suite 125 Doral, FL 33166. I am a: Guest Member Provider Attachments cannot be sent using this secured form. Bureau of Health Promotion and Risk Reduction. Existing participating medical providers in Aetna's network, find forms, update your information, and more using our Provider Onboarding Center. Phone: 888-287-4206 or email us at . For your convenience, we have a single post office box for claims and specialty authorization submissions. claim for medical, dental, vision, or pharmaceutical services. BOX 14586 LEXINGTON, KY 40512-4586 Payer - Aetna Attachment Fax Number - 859-455-8650 Attachment Mailing Address - PO Box 981106 El Paso, TX 79998-1106 You can also reach us Monday through Friday from 7 a.m. 7 p.m. Central time. Aetna ID number (as shown on your Aetna ID card) Date of birth . To reach us by phone, dial the toll-free number on the back of the patient's ID card. Optional Services that you may have purchased through Aetna: Life Insurance 1-800-523-5065: Dental . phone number, office hours, email, and more. Stick to these simple instructions to get Aetna Dental Claim Form - Iu ready for sending: Choose the document you want in our collection of legal templates. Fast, accurate and secure transactions. If you have questions about claims or benefits, we're happy to help. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and Electronic Remittance Advice. PO Box 7083. Can I submit an Aetna claim online? Call 1-877-459-6604 Health Plans Retiree Center Resources Member tools Enroll now Member Login/Register Connect Live Dental PPO Plan - FAQs Select a question below for more info Dental PPO Plan Click on a question. Please make sure each invoice has the following: Member name and ID number (from the member's Aetna International identification card) Name of the member's employer. Faxing us at 1-844-705-2352. Employer's Name 2. Allina Health | Aetna has a dedicated customer team trained to answer your questions. Aetna Maternity Program 855-282-6344. Easily fill out PDF blank, edit, and sign them. Benefits of this change There are three immediate benefits of using this new fax number. b) Visit the treatment providers on the list for out-patient treatment. Paper Claims: Aetna Better Health of Kansas - Claims. While only your doctor can diagnose, prescribe or give medical advice, the Care Management nurses can provide information on a variety of health topics. 3. Active Retired Date of Retirement 7. Once processing is complete, we'll send you a confirmation letter. About the Plan Phone * ZIP Code * d) The treatment provider will then deal with your claim administration. or email us at MA SG Plan Sponsor Inquiries Fax: 866-847-4039: back to top. Fax number; If you're submitting online, you'll need: . TO BE COMPLETED BY . HMO Based Plans (California) 800-624-0756. contact the Quality Management Department at AetnaBetterHealthPAQM@aetna.com. An appeal is a formal way of asking us to review and change a coverage decision we made. Policy/Group Number 3. Filing instructions: Please submit the form within 365 days of receiving the service or item. Call Headquarters on 1-800-US-AETNA (1-800-872-3862) Tweet Aetna Customer Care. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Mail this completed form and your original rece ipts and itemized bills to the medical claims address on your Aetna member ID card. EFT form (PDF) You'll want to allow up to 15 days for us to process your EFT form. Patient name. (Exception: Some members have plans with a dedicated service team.) In some cases, we may allow exceptions for a service or drug that is normally not covered. Instead, download the form (English | Espaol) or call the Member Services number on your member ID card for a prescription drug claim form. Aetna Inc. and its subsidiary companies assume no . If you are already an Aetna Dental Insurance Member and have a question regarding your existing policy or claim, please visit Aetna.com or call 1-800-872-3862. . Aetna Provider Phone Number List (California) Aetna Medicare Advantage Plans and. . Date each service was performed. Overseas Phone Number 480-445-5106. Certain vision claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care ("EyeMed"), LLC. Members. . Suspect fraudulent activity? Aetna Life Insurance Company, located at 151 Farmington Avenue, Hartford, CT 06156, 1-877-698-4825 (TTY: 711), is the Discount Plan Organization. Aetna complaints contacts. 24 hours a day/7 days a week. Links to ClaimConnect and its content are provided for your convenience. Resources. a) Check that your treatment is covered under the plan if you are unsure, contact us. Employee's Aetna ID Number 4. 7 days a week, 8 AM to 8 PM. You should send all faxes to 1-833-596-0339. Box 14094 Lexington, KY 40512-4094 All dental Medicare claims To speak to someone about your Allina Health | Aetna coverage, you can call the Member Services phone number on your member ID card. . Employee's Name 5. Visit Contact Member Services. Phone number (with area code): - - . Mail this completed form and your original receipts and itemized bills to the medical claims address on your Aetna Medicare member ID card. Get an answer. All other Plans (California) 888-632-3862. Once you complete the EFT form, you can submit it by: Emailing us. The benefits of an ERA. It attaches incoming clinical information to pending precertification and concurrent review files.
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