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Dispute & Appeals Overview

Information to guide you

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The dispute process made simple

The dispute process allows you to disagree with a claim or utilization review decision.

Discover how and when to submit a dispute. Learn about the timeframe for appeals and reconsiderations. And find contact information for different issues.

Learn more about the dispute process
View our dispute process quick reference guide

Have more questions?

Read our FAQs. We have answers to many questions, including:

What is a dispute?
What is the procedure for disputing a claim decision?
What is a reconsideration?
What is an appeal?

See frequently asked questions

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State-specific information

We have state-specific information about disputes and appeals. We also have a list of state exceptions to our 180-day filing standard. Exceptions apply to members covered under fully insured plans.

View state exceptions to the filing standard

Transforming health care, together

Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.

Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy^® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health^® family of companies.

98point6^® is a registered trademark of 98point6 Inc. Access to 98point6^® is not included in all plans. 98point6 is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan.

Availity^® is a registered trademark of Availity, LLC.

This material is for information only. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Banner|Aetna. Provider participation may change without notice.

Health insurance plans contain exclusions and limitations.