This form for use in litigation against an insurance company for bad faith breach of contract. Adapt this model form to fit your needs and specific law. Not recommended for use by non-attorney.
Subrogation For Aetna In Oakland
Category:
State:
Multi-State
County:
Oakland
Control #:
US-000279
Format:
Word;
Rich Text
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FAQ
“Providers” can include doctors, psychologists, or physical therapists, and health care facilities, like hospitals, urgent care clinics, or pharmacies. Insurance companies may have different networks for different plans, so make sure you search the provider network of each specific plan you compare.
Aetna® group of companies. Aetna is proud to be a part of the CVS Health® family of companies.
Availity is now our sole provider portal Submit claims, send supporting documentation and check status. View remittances and EOBs. Request authorizations and referrals. Access Aetna specific resources.
Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are both within the CVS Health family.
Aetna offers Medicaid insurance plans in many states. Aetna also runs Children's Health Insurance Plan (CHIP), Medicare Advantage, behavioral health and long-term care programs in some states.
Aetna Signature Administrators® is the brand name for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Use the CPT Code 99404 in order to indicate the sessions is billed under EAP.
EAP claims should be submitted through Provider Express or on a CMS-1500 claim form using the standard "HJ" modifer in section 24D.
You can submit claims online or resubmissions through ConnectCenter.
More info
You can submit claims online or resubmissions through ConnectCenter. This is our free provider claims submission portal via Change Healthcare.Find the forms and documents you need. Find forms and applications for health care professionals and patients, all in one place. Address, phone number and practice changes. You can call the Member Services number on your ID card for personalized service. Complete items twenty-nine (29) through forty-eight (48) in full. 2. Our trained agents are ready to help you choose the right plan for your needs. 1- (TTY: 711) Call us Monday to Friday, 8 AM to 9 PM ET. Get reimbursed for the money that you paid for covered dental and medical services.