Aetna

Claim Status

Overview
Terminology
Frequently Asked Questions
  Why would a claim not be displayed?

Overview

Claim Status allows you to choose criteria for your Claim Summary page. The Claim Summary page lists the status of claims that are in our claims processing system – the system that determines claims resolution and, when appropriate, payment amounts based upon your plan's rules and claims information.

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Terminology

Claim Status Terminology:
Term
Description
Member Name

This box allows you to choose how you view your own and your covered dependents' claims. You can choose to view claims for your medical or dental plans by selecting one of the following options:

  • All covered members at once OR
  • Each individual covered member

Note: The date of birth for each member is displayed to assist you with your member selection.

Service Date Range

You have the option to enter a date range to narrow the search for claims to a particular period of time, or you can use the date the service occurred. If you wish to display all available claims, then leave the date range blank.

Type of Claim

Choose the type of claim you want to view:

  • Medical OR
  • Dental

Note: Vision, hearing, pharmacy or dental claims may be included with your medical coverage claims when you select Medical Claims Summary.


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Frequently Asked Questions

Why would a claim not be displayed?
  • Claim Search may list some treatments, such as oral surgery, as either a dental or a medical claim. When you do a Claim Search, please check both lists.
  • If your claim search results in an error message:
    • Hit the ‘Back’ button on your browser and return to Claim Search
    • Try to narrow your search on a specific Member Name or Service Date Range
    • Select ‘Go’.

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