Aetna Medicare Claim Form. Web fill out this form if you’re asking for a medical, dental, hearing aid or vision reimbursement and you were billed by a provider who did not bill us directly.don’t use this form for a prescription drug reimbursement.please call the number on your member id card for help with prescription drug reimbursements. Web find the aetna medicare forms you need to help you get started with claims reimbursements, aetna rx home delivery, filing an appeal and more.
In addition to your member id, you'll need a clear image of your receipt (s) ready for upload. Web fill out this form if you’re asking for reimbursement of a covered a medical service, dental service, eyewear, hearing aid, vaccine or fitness reimbursement you paid a doctor, healthcare professional, or service provider who did not bill us directly. Make copies of all of your receipts and itemized bills from your provider. Address, phone number and practice changes behavioral health precertification coordination of benefits (cob) employee assistance program (eap) medicaid disputes and appeals medical precertification medicare disputes and appeals medicare precertification Be sure to include your aetna member id number on each receipt and bill. Information on filing claims online • keep a copy of all documents submitted for your records. Where to send the completed form? Please allow additional mail time. Web fill out this form if you’re asking for a medical, dental, hearing aid or vision reimbursement and you were billed by a provider who did not bill us directly.don’t use this form for a prescription drug reimbursement.please call the number on your member id card for help with prescription drug reimbursements.
Where to send the completed form? • keep a copy of all documents submitted for your records. • do not staple or tape receipts or attachments to this form. • your complete claim will be processed within 14 days of receipt of your request. Web file a aetna medicare insurance claim online. To find forms customized for your benefits, log in to your member account. Web find the aetna medicare forms you need to help you get started with claims reimbursements, aetna rx home delivery, filing an appeal and more. It takes approximately 10 minutes to complete. Web fill out this form if you’re asking for a medical, dental, hearing aid or vision reimbursement and you were billed by a provider who did not bill us directly.don’t use this form for a prescription drug reimbursement.please call the number on your member id card for help with prescription drug reimbursements. Please enter your member id and date of birth to get started. All materials submitted will be retained by us and cannot be returned to you.
