Aetna

Out-of-Network Claims Made Simple

File Aetna reimbursement claims in 5 minutes.80% average reimbursement rate • 25 day processing

Generate Aetna ClaimView Filing Guide
80%
Avg Reimbursement
25 Days
Processing Time
HCFA 1500
Preferred Form
98%
Success Rate

Aetna Claims Contact Information

Phone
1-800-872-3862
Email Claims
claims@aetna.com
Website
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Aetna Claim Filing Tips

Include procedure codes

Attach EOB from primary insurance if applicable

Submit within 120 days

Include tax ID number

Pro Tip for Aetna Claims

Using ClaimBridge ensures all required fields are completed correctly, reducing claim denials by 73% and speeding up reimbursement by an average of 10 days for Aetna claims.

Start Your Aetna Claim Now

Upload your invoice and we'll generate the perfect HCFA 1500 form for Aetna

Upload Your Medical Documents

Upload invoices, EOBs, or medical documents to extract claim information automatically

Aetna Claims FAQ

How long does Aetna take to process out-of-network claims?

On average, Aetna processes out-of-network claims in 25 days. Using ClaimBridge's optimized forms can reduce this time.

What is the average reimbursement rate for Aetna out-of-network claims?

Aetna typically reimburses 80% of allowed charges for out-of-network services, depending on your specific plan.

What forms does Aetna require for reimbursement?

Aetna prefers the HCFA 1500 form for out-of-network claims. ClaimBridge automatically generates this form with all required information.

Can I submit Aetna claims electronically?

Yes, ClaimBridge can help you submit claims electronically to Aetna or prepare them for email/mail submission based on your preference.

Complete Guide to Aetna Out-of-Network Claims

Filing out-of-network claims with Aetna doesn't have to be complicated. Whether you've seen a therapist, specialist, or other healthcare provider who doesn't accept Aetna insurance directly, you can still get reimbursed for your medical expenses.

Understanding Aetna Out-of-Network Benefits

Aetna typically covers out-of-network services at 80% of the allowed amount after you meet your deductible. The exact percentage depends on your specific plan - PPO plans generally offer better out-of-network coverage than HMO or EPO plans.

What You Need for Aetna Reimbursement

  • Completed HCFA 1500 claim form
  • Itemized invoice or superbill from your provider
  • Proof of payment (receipt or credit card statement)
  • Any additional documentation specific to your treatment

Aetna Claim Submission Methods

You can submit your Aetna out-of-network claim through multiple channels:

  • Online through the Aetna member portal
  • By email to claims@aetna.com
  • By mail to the address on your insurance card
  • By fax (check your plan documents for the number)

Maximizing Your Aetna Reimbursement

To get the maximum reimbursement from Aetna, make sure to:

  1. Submit claims within the filing deadline (usually 90-365 days)
  2. Include all required documentation
  3. Use the correct procedure and diagnosis codes
  4. Verify your out-of-network benefits before treatment
  5. Keep copies of everything you submit

Common Aetna Claim Denial Reasons

The most common reasons Aetna denies out-of-network claims include:

  • Missing information on the claim form
  • Submission after the filing deadline
  • Service not covered under your plan
  • Incorrect procedure or diagnosis codes
  • Missing provider information or NPI number

ClaimBridge helps you avoid these common mistakes by automatically checking your claim for completeness and accuracy before submission.

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