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Reminder: Your appeal request must include a completed Aetna complaint and appeal form


A completed Aetna Provider Complaint and Appeal form is required when submitting provider appeals. Please submit your appeal request with the fully completed form and any additional medical records, notes or other documentation you would like reviewed with your request. Please note that this is not a new requirement or process.



Dispute and Appeals process


For an overview of Aetna’s Disputes and Appeals process or to obtain a copy of the Aetna Provider Complaint and Appeal form, visit


We hope this reminder will be helpful as we partner together to provide care and benefits to our members.