Health Plan - Aetna

Appeal Process

• Aetna Appeal Process for State of Delaware Aetna CDH Gold and HMO Health Plans 
  To request a review or appeal the processing of claims for health care services, member must complete the following two forms and submit to the Statewide Benefits Office (SBO):

  • *State of Delaware Authorization for Release of Protected Health Information Form 

  • *Appeal Form and Checklist for Filing a Level III Appeal of Prior Denial to SBO 

• Non-Medicare Prescription Plan Appeal Process

• Lantern Appeal Process

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