Claims Procedures
All medical claims should be submitted to: | All Non-medical Claims should be mailed to: |
---|---|
Aetna Student Health P.O. Box 981106 El Paso, TX 79998 | CIEE-Insurance Department 600 Southborough Drive, Suite 104 South Portland, Maine 04106 |
If your mailing address has changed you MUST contact 黑料网911IMMEDIATELY in order to update your address on file with Aetna Student Health. Please contact 黑料网911BEFORE submitting your claim for reimbursement if your address has changed.
Medical and Prescription/Medication Claims
Medical
If you鈥檝e paid for medical services, other than your required co-pays, please follow the directions below in order to receive a reimbursement.
All bills and a completed Claim Form must be submitted within 90 days from the date of treatment. Payment for covered medical expenses will be made directly to the hospital or physician concerned unless the insured person submits proof of payment. When submitting a Claim Form, attach all available itemized medical bills, statements and invoices for services and supplies to the Claim Form.
Prescription
You may obtain your prescription/medication from any pharmacy and you will be required to pay in full at the time of service for all prescriptions. You will be reimbursed for covered medications at the reasonable charge allowance, less any applicable co-pay, directly from Aetna.
1. Complete the Claim Form.
2. You will need to submit the itemized bill with medical codes and receipts (pharmacy and cash receipts for prescription claims) showing proof of payment for your visit.
3. Mail the medical claim form, itemized bill and receipts to Aetna Student Health鈥檚 address above. Please allow 4 to 6 weeks to process once it鈥檚 received by Aetna Student Health. If you have any questions regarding a claim, please call 黑料网911at 1-888-268-6245 FREE and ask for assistance.
Non-Medical Claims
Please follow the non-medical claims procedures below if you鈥檝e had baggage, valuables, or personal documents stolen or, if a transportation company has lost your baggage, valuables or personal documents while in transit.
In order for claims to be considered for reimbursement an official police report must be filed within 24 hours of discovery of the theft of property. If the loss is in connection with an airline flight, a property irregularity report (PIR) must be obtained by the airline. Copies of the reports and supporting documentation (receipts, proof of purchase, or appraisals, etc.) must be submitted along with a completed Claim Form within 15 days of the loss or theft.
1. Complete the Claim Form.
2. Any claims involving theft will need to include an official police report. Claims for lost baggage will need to include a PIR (property irregularity report) from the airline that lost your baggage. Make sure you obtain this information before submitting your claim.
3. If claiming valuables, you will need to submit receipts, (a valuable is defined as valued at $175 or above). If claiming personal papers, include replacement prices for documents.
4. Send the completed claim form, police report/PIR, and any relevant receipts to the address provided above.
5. Claims submitted for Urgent Travel Expense should include flight itinerary and copy of death certificate.
Personal Liability Claim Procedure
黑料网911must be notified within 5 days of any event that may result in a personal liability or legal assistance claim.
Appealing a Claim
In the event of a disagreement over the payment of a claim, a written request to review the claim must be mailed to Aetna Student Health within 180 days from the date of denial. Please download and complete the Member Complaint and Appeal Form that you will need to include with your request. The request should also include any additional information that supports the claim (e.g., medical records, Physician鈥檚 office notes, operative reports, Physician鈥檚 letter of medical necessity, etc.). Aetna Student Health reviews and determines appeals within 60 days from the date of receipt. Please submit all requests to:
Appeals Resolution Team
P.O. Box 14464
Lexington, KY 40512
If you would like to discuss a denied claim, please call 黑料网911at 1-888-268-6245 FREE and ask for assistance.