Filing a claim with your healthcare company can seem overwhelming and nerve-wracking.
First and foremost, when you see a network provider–your doctor or dentist will file the claim on your behalf. They take the hassle off your plate. And in many cases, a non-network (or out-of-network) provider will also file a claim for you if you ask.
If you use out of network services you will likely need to file the claim on your own for reimbursement. You will want to make sure you have an itemized receipt from your doctors office which will be submitted with this claim. To submit a claim you will want to download a claim form which can be found on www.aetna.com. Once you log into the site, click on your name in the top right corner. The drop down will showcase your options and click on Forms. There you will find the most recent and up to date versions of claim forms for medical and vision.
Downloading the forms will result in a fillable PDF file. You can complete that form and save it so that in the future you don’t have to re-fill all of the top fields like your name, address etc. Because the form needs a signature, you will need to print the completed form and sign. If you have already paid the provider make sure to leave field 28 blank as this ensures that you are the recipient of any reimbursement from Aetna. If your provider anticipates being paid by Aetna directly field 28 authorizes Aetna to do so. Starting at field 29 – you may leave this all blank if you are submitting an itemized receipt which is clear about dates of service and what those services were.
Where to Submit claims: Check the form for up to date information.
Once you have submitted your claim allow a week or two until you should be able to see it in process on the aetna.com website. If you do not see the claim appear in the “claims” section of the Aetna.com site and feel an appropriate amount of time has passed call Aetna at 1-800-338-8047 and they will provide you with a status on the claim.
Claim forms can also be found in the Resources section on The Benefits Center site.
