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Aetna Better Health of Illinois 3200 Highland Avenue, F648 Downers Grove, IL 60515Provider Reconsideration, Appeal and Complaint/Grievance Instructions Provider submissions will be reviewed and processed

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How to fill out abhil - provider dispute

01

To fill out ABHIL - provider dispute form, follow these steps:

02

Begin by providing your personal information such as your name, address, and contact details.

03

Fill in the details of the provider you have a dispute with, including their name, address, and any relevant account numbers.

04

Clearly state the reason for the dispute and provide any supporting documentation or evidence to support your claim.

05

Specify the desired resolution or outcome of the dispute.

06

Sign and date the form before submitting it to the appropriate authority or entity.

Who needs abhil - provider dispute?

01

ABHIL - provider dispute form is needed by individuals who have a dispute or disagreement with a healthcare provider that is part of ABHIL (name of the organization). This form allows them to formally communicate their grievances and seek a resolution.

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