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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

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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 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.

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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 and CVS Pharmacy® are part of the CVS Health family of companies. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are both within the CVS Health family.

Access to the 98point6 application is included in all Banner|Aetna ACA individual & family plans. 98point6 is not available in all Banner|Aetna plans offered through employers. 98point6 is a registered trademark of 98point6 inc.

This material is for information only and is not an offer or invitation to contract. Providers are independent contractors and are not agents of Banner l Aetna. Provider participation may change without notice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Information is believed to be accurate as of the production date; however, it is subject to change.

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