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Medical - Provider Procedures for Submitting Refunds
When a provider realizes that he or she has received an overpayment, the following information should be submitted to Aetna.
- A refund check issued to Aetna in the amount of the overpayment
- Supporting documentation, including but not limited to items such as
- a letter explaining the reason for the refund
- a copy of the provider's Explanation of Benefit statement
- in the case of incorrect coordination of benefits, the primary carrier's explanation of benefits statement
- corrected bill
- any other documentation which would assist in accurate crediting of the refund
- The name and ID number of the member for whom we have overpaid. When available, include a copy of the member's Aetna ID card.
- The date(s) of service involved
The above information should be mailed to the address on the Explanation of Benefits statement or the member's identification card. Once Aetna receives the information, the necessary corrections will be made to the member's file.
If the member's identification card is not readily available, send to the following address:
HMO Submissions
Aetna Inc.
Attn: NCO Check Unit, U23N
980 Jolly Road
Blue Bell, PA 19422
Traditional Submissions
Aetna Inc.
P.O. Box 14079
Lexington, KY 40512-4079
When the overpayment has been identified and requested by Aetna, please mail the check, along with a copy of the letter, to the address provided in the letter.