A Spanish-language line says that to receive this notice in Spanish you should call the toll-free Member Services (Servicios a Miembros) number printed on your ID card. The notice itself, as saved, is in English.
Supporting quotations
Para recibir esta notificación en español por favor llamar al número gratuito de Member Services (Servicios a Miembros) que figura en su tarjeta de identificación.
Qualifications & exceptions
The number to call is the one on the member ID card, not a number given in this notice.
Not stated here
The Member Services number and its hours are not stated in the notice.
Account & Service Control · Company practice
Benefit notices and EOBs go to the member's address on record
Aetna mails notices of benefit determination, Explanation of Benefits forms and other information to the address it has on record for the member. Elsewhere the notice describes ways to ask for a different location or method, and to stop paper mailing (see Your Legal Rights).
Supporting quotations
We also mail notices of benefit determination, Explanation of Benefits forms and other information to the address we have on record for the member.
Qualifications & exceptions
The address on record is the default; the rights section describes how to ask for a different arrangement.
Not stated here
The notice does not say how quickly a changed address or stopped paper mailing takes effect.
Account & Service Control · User right or choice
Right to ask for communications in a certain way or place
You have the right to ask Aetna to communicate with you in a certain way or at a certain location. For example, if you are covered as an adult dependent, you might want health information such as EOBs and other claim information sent to a different address from your subscriber's. Aetna says it will accommodate reasonable requests. This is an alternative to the default practice of mailing benefit notices and EOBs to the member's address on record.
Supporting quotations
You have the right to ask us to communicate with you in a certain way or at a certain location.
For example, if you are covered as an adult dependent, you might want us to send health information (e.g. Explanation of benefits (EOB) and other claim information) to a different address from that of your subscriber.
We will accommodate reasonable requests.
We also mail notices of benefit determination, Explanation of Benefits forms and other information to the address we have on record for the member.
Qualifications & exceptions
Aetna commits to accommodate only reasonable requests.
The default is mailing to the address on record.
Not stated here
The notice does not say what Aetna treats as an unreasonable request.
Cross-references
qualifies (model-proposed): Benefit notices and EOBs go to the member's address on record — qualifies: The right to ask for communications at a different place or by a different method qualifies the default of mailing benefit notices and EOBs to the address on record.
Account & Service Control · User right or choice
You can stop paper EOB mailing online
You may stop the paper mailing of your EOBs and other claim information by visiting www.aetna.com, selecting Log In/Register and completing a one-time registration. After that you can log in at any time to view past copies of EOBs and other claim information.
Supporting quotations
You may stop the paper mailing of your EOB and other claim information by visiting www.aetna.com and click “Log In/Register”.
Follow the prompts to complete the one-time registration. Then you can log in any time to view past copies of EOBs and other claim information.
Qualifications & exceptions
Requires the one-time online registration at www.aetna.com.
Not stated here
The notice does not say whether stopping paper mailing changes how other mailed notices are delivered.
Right to ask for a copy of your designated record set
You have the right to ask Aetna for a copy of health information in a 'designated record set', meaning records maintained and used in making enrollment, payment, claims adjudication, medical management and other decisions. Aetna may ask you to make the request in writing, may charge a reasonable fee for producing and mailing the copies, and in certain cases may deny the request.
Supporting quotations
You have the right to ask us to obtain a copy of health information that is contained in a “designated record set” – records maintained and used in making enrollment, payment, claims adjudication, medical management and other decisions.
We may ask you to make your request in writing, may charge a reasonable fee for producing and mailing the copies and, in certain cases, may deny the request.
Qualifications & exceptions
Aetna may require the request in writing.
Aetna may charge a reasonable fee for producing and mailing copies.
Aetna may deny the request in certain cases.
Not stated here
The notice does not say when a request may be denied, or what the fee is.
Account & Service Control · User right or choice
Right to ask Aetna to amend your records
You have the right to ask Aetna to amend health information in a designated record set. The request must be in writing and include the reason. If Aetna denies the request, you may file a written statement of disagreement.
Supporting quotations
You have the right to ask us to amend health information that is in a “designated record set.” Your request must be in writing and must include the reason for the request.
If we deny the request, you may file a written statement of disagreement.
Qualifications & exceptions
The request must be in writing and include the reason.
If denied, your remedy stated here is a written statement of disagreement.
Not stated here
The notice does not say what happens to a statement of disagreement or when Aetna agrees to amend.
Account & Service Control · User right or choice
Right to a list of certain disclosures
You have the right to ask Aetna for a list of certain disclosures it has made about you, such as disclosures of health information to government agencies that license it. The request must be in writing. If you ask for such an accounting more than once in a 12-month period, Aetna may charge a reasonable fee.
Supporting quotations
You have the right to ask us to provide a list of certain disclosures we have made about you, such as disclosures of health information to government agencies that license us.
Your request must be in writing. If you request such an accounting more than once in a 12-month period, we may charge a reasonable fee.
Qualifications & exceptions
The list covers 'certain' disclosures, not every disclosure.
The request must be in writing.
A reasonable fee may apply after the first request in 12 months.
Not stated here
The notice does not say which disclosures are excluded from the list.