Aetna Reimbursement Form

By PolicyBazaar
  | Published: 16 June 2021 | Last Updated On: 18 June 2021

Don’t gamble with your health, get the right cover at the right price.

Average Rating / 5 (ratings ) | 152 Views

Aetna is a USA-based health insurance company that is also one of the most popular health insurance providers in the UAE. Aetna offers some of the best and most preferred health insurance plans in the country. Apart from being one of the most preferred health insurance companies for their insurance plans and benefits, Aetna is also well-known for its remarkable claim settlement process and ratio. Since Aetna is an international health insurance company, it provides a common Aetna international claim form for all reimbursement-related health insurance claims. Let us understand the process of filling Aetna reimbursement form more clearly. 

Download Aetna Reimbursement Claim Form

Aetna Complete Claim Process

The claim process of Aetna reimbursement claims is rather simple. It is inclusive of the following given three simple steps:

  • Step 1: Obtain and fill out the Aetna international reimbursement form. The next section contains the steps you need to follow to fill out the form.
  • Step 2: Collect and attach all the required documents with the claim form and prepare a package that needs to be submitted. 
  • Step 3: Submit the document set along with the Aetna reimbursement form using the available submission channels. 

The following sections will explain these steps in detail including everything you will need in order to fill the Aetna reimbursement form ideally. The international reimbursement form is a bit lengthier as compared to other reimbursement forms so that all the information can be recorded in one place. Make sure you diligently follow the steps to avoid missing out on important information.

How to Fill Aetna Reimbursement Form?

  • The first step is to download the Aetna reimbursement form and take a print of the same to fill it out. Make sure that you have used the right download links for the form. You can find the reimbursement that you will need on Policybazaar.ae or Aetna International website. 
  • You do not need to download the form if you plan to make an online submission. Also, make sure that you download the right form as there can be multiple forms such as the basic reimbursement form or the Aetna dental reimbursement form.
  • The first section is to be filled with the personal information of the insured person. This includes name, member ID, plan number, date of birth, etc. All this information must be present on your Aetna membership card so make sure that the form matches it ideally. 
  • The second section is to be filled out in case someone else is initiating the claim on the behalf of the insured person. The details to be filled in here are the same as the first sections including name, phone number etc. The member ID must be of the claimant though. 
  • Section 3 will include the contact details that are related to the claim in question. Fill out the section with the relevant details related to your phone number, address, etc. 
  • Section 4 requires you, the claimant, to mention the symptoms of the conditions that you noticed. Take your time and explain the symptoms in detail. Also mention the name of the condition. 
  • Section 5 contains the declaration part where you need to sign and date the form. 
  • Section 6 is to identify the type of health insurance claim that you are initiating. There are 6 sections you need to choose from. The options include – general wellness check-up, optical care checkup, repeat prescription or existing medical condition, outpatient physiotherapy, Chinese medicine/chiropractic/etc. treatment and hospital cash benefit. 
  • Choosing any of the first 5 options will exempt you from filling out section 8. You must fill out the details as asked for each section that you choose from the list. 
  • If you choose option 6 from the section 6 list, fill out the table below by adding the treatment/service received, date, invoice date, invoice reference number, and amount. Make sure you add all the services that you want to reimburse here. 
  • You can use an additional sheet of paper if you need to record more invoice numbers and details.
  • Fill out the last three questions in section 6 with a simple yes or no answer and correspond as asked for each question. 
  • Section 7 will contain all the bank details of the account you want the settlement to be transferred to. Be extremely careful while filling out these details here. 
  • Section 8 needs to be filled only if you are reimbursing for hospital care benefits as selected in Section 6. 
  • Section 8 shall be filled out by your doctor or medical officer overseeing the treatment. It will include contact details of the doctor in column 1, symptoms as noted by the doctor in column 2, diagnosis in column 3 with a detailed description, alternate treatments in column 4 (if any), referrals in column 6 (if any), hospitalization details in column 6 and finally a declaration of the doctor in column 7. 

What are the Documents Required for Aetna Reimbursement Form?

You are required to send out the following documents attached with the Aetna reimbursement form:

  • All the original invoices with paid receipt from the vendors
  • Separate invoices for payments made with cards. Credit and debit card statements can not be used here.
  • A copy of the prescriptions of the drugs you are claiming the reimbursement for.
  • All investigative tests related to the condition including blood tests, MRI, CT Scans, x-rays, etc.
  • A copy of the complementary medicine suggested by the doctor
  • A copy of diagnostics tests and other lab tests related to the incident/illness
  • A copy of all admission and discharge documents from the hospital

Scan all the documents as pdf files if you are making an online submission of the Aetna reimbursement claim form.

How to Submit Aetna Reimbursement Form?

There are four basic ways for you to submit your Aetna reimbursement form. This includes both online and offline channels. Following is a description of submission ways:

  • Online via Aetna Claim Portal: You can use Aetna online claim portal to fill out and submit the Aetna reimbursement form. Make sure you upload a high-quality scanned copy of the document required on the portal as well. 
  • Online via Email: You can also submit your Aetna claim form online using the official email address of the company. The email address will be given on the last page of the reimbursement claim form so you can pick it up from there if you can not find it online.
  • Offline via Fax: Aetna fax machine number can also be used to forward your Aetna claim form and documents. Once again, you can either retrieve the fax number from the website or the last page of the claim form. 
  • Offline via Mail: You can also stick to the traditional manner if you like and send out the Aetna claim form via mail to their branch office in the UAE. Aetna UAE's main office is located in Dubai and the address can be taken from the website or the claim form itself. 

Things to Keep in Mind When Filling Aetna Reimbursement Form

  • The payment of the reimbursement claim will be made to the insured person/claimant if they are 18 years old or older.
  • Planholder shall receive the payment if the claimant is below 18 years of age.
  • The claim will only go under processing if it contains – a proper, detailed diagnosis of the condition, date of treatment, the type of treatment received, and the official stamp of the medical officer/doctor. 
  • Make a copy of all the original documents and receipts that you submit with the claim form. The company will not return the original document if the claim is approved. 
  • Make sure that you have made no mistake on the claim form before submitting it. Even the smallest of errors can result in claim rejection and then you will have to go through the whole process again. 
  • Ensure that all the receipts, invoices, and other documents are either in English and Arabic. The documents that are originally in any other languages must be translated by an official public translator of the country. 
  • One form can only be used for a single claimant. If there is more than one claimant covered in the same policy, or different ones, that need to make a claim, then they will have to use separate forms. 
  • You can submit the claim within 180 days of the incident/illness/accident and the treatment that you are claiming.
  • The single-level claims are generally all settled and paid out in 60 days and the claims with two levels of appeal will take 30 days. 
  • You can submit a review of the claim settlement within the next 60 days of the settlement date if you do not agree with the decision. 

Conclusion

Aetna international claim form is a bit lengthier and may seem a bit difficult to complete at the first glance. However, the process is very simple. All you will need is the right information on hand and the documents mentioned above. Just make sure that you do not make any clerical errors in the forms and submit all the mentioned documents with utmost care. There is a checklist of documents given on the form to help you recheck everything once again.