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Aetna Better Health of Virginia 9881 Maryland Drive Richmond, VA 23233 AETNA BETTER HEALTH OF VIRGINIA Provider Claim Reconsideration form Please complete the information below in its entirety and

How to fill out claims resubmission form

How to Fill Out Claims Resubmission Form:

1. Start by reviewing the reason for the claim resubmission. It could be due to errors in the original claim, missing information, or a request for additional documentation.
2. Obtain a copy of the original claim form and any accompanying documents to reference while completing the resubmission form.
3. Fill out the resubmission form accurately and precisely. Make sure all required fields are completed, including the patient's information, provider's information, and details of the service or treatment being claimed.
4. Double-check the accuracy of the information entered, ensuring that it matches the original claim. This includes verifying the patient's identification number, dates of service, and any relevant diagnosis or procedure codes.
5. If the resubmission is due to an error or omission on the original claim, clearly explain the reason for the resubmission in the designated section of the form. Provide a brief and concise explanation to help expedite the processing of the claim.
6. Include any additional documents that may be necessary to support the resubmission. This could include medical records, test results, or any other relevant documentation requested by the insurer.
7. Before submitting the form, make a copy for your records. It's important to have documentation of the resubmission process in case any issues arise.
8. Once the form is completed, submit it according to the instructions provided by the insurance company or healthcare payer.
9. Keep track of the resubmission by noting the date it was submitted and any communication received from the insurance company. Follow up if necessary to ensure the claim is being processed correctly.
10. It's important to note that not everyone will require a claims resubmission form. Only individuals who have had a claim denied, rejected, or need to provide additional information should utilize this form. It's recommended to consult with your healthcare provider or insurance company if you are unsure if you need to fill out a claims resubmission form.

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What is claims resubmission form?

A claims resubmission form is a document used to resubmit a previously filed insurance claim that was denied or rejected.

Who is required to file claims resubmission form?

Any individual or healthcare provider whose insurance claim was denied or rejected is required to file a claims resubmission form.

How to fill out claims resubmission form?

To fill out a claims resubmission form, you need to provide all the necessary information requested, including details about the original claim and the reason for resubmission.

What is the purpose of claims resubmission form?

The purpose of a claims resubmission form is to correct errors or provide additional information in order to have a previously denied or rejected claim reconsidered.

What information must be reported on claims resubmission form?

The claims resubmission form must include details about the original claim, reasons for resubmission, any new or corrected information, and any supporting documentation.