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Attending Physician Statement
Complete and sign the form using BLUE or BLACK ink. Aetna Life Insurance Company
PO Box 14560
Lexington, KY 405124560The Genetic Information Nondiscrimination Act of
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How to fill out attending physician statement
How to fill out Aetna GC-1486-26
01
Obtain the Aetna GC-1486-26 form from Aetna's website or your provider.
02
Fill out the patient information section, including the patient's name, date of birth, and member ID.
03
Complete the provider information portion with the relevant details of the healthcare provider treating the patient.
04
Indicate the medical services received in the designated section, providing dates and descriptions of the services.
05
Attach any necessary documentation, such as medical records or invoices, that support the claim.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form before submitting it to Aetna.
Who needs Aetna GC-1486-26?
01
Individuals who are Aetna members and have received medical services that need to be reimbursed.
02
Healthcare providers who are submitting claims on behalf of their patients to Aetna.
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What is Aetna GC-1486-26?
Aetna GC-1486-26 is a specific form used by Aetna for reporting certain health-related data or claims.
Who is required to file Aetna GC-1486-26?
Healthcare providers, organizations, or individuals who have claims or data to report to Aetna are typically required to file Aetna GC-1486-26.
How to fill out Aetna GC-1486-26?
To fill out Aetna GC-1486-26, one must provide the required information in the designated fields, ensuring accuracy and completeness before submission.
What is the purpose of Aetna GC-1486-26?
The purpose of Aetna GC-1486-26 is to facilitate the reporting and processing of health-related claims or data to ensure appropriate handling by Aetna.
What information must be reported on Aetna GC-1486-26?
The information that must be reported on Aetna GC-1486-26 typically includes patient details, claim specifics, provider information, and any relevant clinical data.
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