How to Appeal an Aetna Insurance Denial
Aetna (a CVS Health company) is one of the largest health insurers in the United States. Aetna processes appeals through their dedicated appeals department. Like many large insurers, Aetna uses automated claim processing systems that can result in denials that don't reflect the actual clinical situation.
Appeal Address
Aetna Appeals, P.O. Box 14463, Lexington, KY 40512-4463
Appeal Phone
1-800-756-7039
Timely Filing
90 days
Appeal Deadline
180 days from denial
Common Aetna Denial Patterns
- ⚠Frequently downcodes E&M visit levels without chart review
- ⚠Bundles chiropractic and physical therapy services aggressively
- ⚠Requires AT modifier on chiropractic claims
- ⚠Known for applying UCR reductions below contracted rates
Common Denial Types from Aetna
Medical Necessity
56% of medical necessity denials are overturned on appeal when properly documented.
Prior Authorization Denial
62% of prior authorization denials are overturned on appeal.
Claim Coding Error Denial
71% of coding error denials are resolved successfully — the highest rate of any denial type.
Appeal your Aetna denial
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