Aetna provider appeals fax number (2026)

Aetna prints 859-455-8650 as its national fax number for provider appeals on its Practitioner and Provider Complaint and Appeal Request form. The form reads "Or use our National Fax Number: 859-455-8650," and Aetna's Disputes and appeals page lists the same number for commercial plans. Medicare appeals use two other lines, shown below.

Which Aetna fax number goes with my appeal?

Aetna's page adds that state-specific exceptions may apply. The commercial form's first instruction is to send your request to the address on your explanation of benefits or other Aetna letter. The national fax number is the alternative.

As of October 7, 2026, two groups follow other routes. Aetna's forms page says Medicaid providers serving Aetna Better Health patients must use the process indicated by the health plan they serve. Aetna Dental's dispute page describes a separate route for dental plans, so a dental office should call 1-800-451-7715 to confirm where to send an appeal.

Is this a reconsideration or an appeal?

Aetna takes claim disputes two ways and charges for neither. A reconsideration is a formal review of a previous claim decision: a reimbursement decision, a coding decision or a claim that needs reprocessing. An appeal is a written request to change or overturn a decision, including a reconsideration decision, and it covers medical necessity, payment policy and experimental or investigational rulings.

The fax numbers sit under appeals. A reconsideration goes through Availity or by mail, to the address on the denial letter or EOB or to Aetna's state mailing address.

The clocks differ. A reconsideration is due within 180 calendar days of the initial claim decision, and an appeal within 60 calendar days of the reconsideration decision. A claim that skips reconsideration goes straight to appeal, with up to 180 days for Medicare and commercial plans and up to 65 days for Medicare non-contracted providers. Aetna decides appeals by mail or fax within 60 business days. Aetna's 180-day filing standard holds unless a state exception sets a different period, and its provider appeals page lists those exceptions, which cover fully insured plans only.

What goes in an Aetna appeal packet?

Aetna names three requirements for a valid appeal:

• The completed dispute and appeal form, which is not needed when you file through Availity
• A written explanation that identifies the denied codes or payments
• Medical records and other relevant documentation

It also asks for the denial letter or EOB and the original claim for reference, plus remittance advice or office notes where you have them. Aetna warns that an incomplete submission may affect how it handles the appeal.

The form asks for the member's ID and plan type, your name and TIN or NPI, a contact with a fax number, the claim IDs, any authorization number, the service dates, the initial denial and reconsideration denial dates, the CPT or HCPCS code in dispute, and your explanation. One form can cover several dates of service for the same member.

Two redirects are on the forms. If you act for the member with a signed authorization, or you appeal a preauthorization denial for services not yet rendered, use Aetna's member complaint and appeal form instead. That form prints its own fax number, 859-425-3379 on the GR-68192 (8-25) edition, so use the number on the form you download. A Medicare non-contracted provider adds a completed Waiver of Liability form.

What goes on the cover sheet?

The recipient: the Aetna Provider Resolution Team for commercial plans, Medicare Provider Appeals or Medicare Non Contracted Provider Appeals for Medicare. Then your practice's name, phone and return fax, the date and the page count. The member's ID and the claim numbers belong on the form behind it, not on the cover. Claim review is a payment activity under 45 CFR 164.501, so the minimum necessary standard in 45 CFR 164.502(b) applies to what you attach.

How do I send an appeal from a HIPAA fax account?

An appeal packet carries member records, so the fax service that sends it is a business associate under 45 CFR 160.103, and every Fax Pigeon plan includes the signed BAA, executed at signup.

Combine the form, your explanation, the denial letter and the records into one PDF. Upload it, or send it from your email, enter the number for the plan and send. Then file the delivery certificate with the appeal. It records when the pages arrived, which is the date to hold against Aetna's 60-day and 180-day clocks.

A billing office that files appeals for several practices can work from one number and one inbox with unlimited people, and a decision that comes back by fax can be assigned to the person handling that claim (HIPAA fax for medical billing companies). Plans start at $4.99 a month billed annually for 200 pages sent and received combined (plans and pricing).

What if the fax fails or Aetna changes the number?

If no delivery certificate arrives, resend once. Then call Aetna to confirm receipt: 1-888-632-3862 for commercial plans, 1-800-624-0756 for Medicare. Aetna also takes initial disputes through Availity.

Aetna prints a form number and a revision date at the foot of each form, such as GR-69140 (3-17). Download the form from Aetna's Forms for Health Care Professionals page rather than reusing a saved copy, and compare the fax number on it with the table above. A misdial sends a member's record to a stranger.

* Fax number verified October 7, 2026, on Aetna's own Disputes and appeals overview page (https://www.aetna.com/health-care-professionals/disputes-appeals/disputes-appeals-overview.html), which lists all three numbers. Confirm it on the current form before you send patient information. Fax Pigeon is not affiliated with Aetna.