Complaints, Grievances & Appeals

Aetna Better Health and our contracted providers are responsible for timely resolution of any disputes between both parties. Disputes will be settled according to the terms of our contractual agreement and there will be no disruption or interference with the provision of services to members as a result of disputes.

Aetna Better Health will inform providers through the Provider Manual and other methods, such as newsletters, training, provider orientation and our website, about the provider dispute process.

Aetna Better Health’s Provider Services Representatives are available to discuss a provider’s dissatisfaction of an issue covered by this policy, and if unable to satisfy the provider’s inquiry, the Provider Complaint Process will be offered.

Both network and out-of-network providers may file a complaint verbally or in writing directly with Aetna Better Health in regard to our policies, procedures or any aspect of our administrative functions.

The Appeals and Grievance Manager assumes primary responsibility for coordinating and managing provider complaints, and for disseminating information to the provider about the status of the complaint.

Aetna Better Health of New York
Appeal and Grievance Department
PO Box 81040
5801 Postal Road
Cleveland, OH 44181