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Dispute and appeals overview.

Information to guide you.

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.

Medicare appeals

Learn about Medicare hospital discharge appeals, as well as
non-participating provider payment appeals.

Learn more about Medicare appeals

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

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

Legal Notices: Health benefits and health insurance plans contain exclusions and limitations.

Health benefits and health plans are offered, underwritten or administered by Allina Health and Aetna Insurance Company (Allina Health | Aetna).  Allina Health l Aetna is an affiliate of Aetna Life Insurance Company and its affiliates (Aetna).  Allina Health | Aetna has sole responsibility for its products and services. Aetna provides certain management services to Allina Health | Aetna. 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.

Allina Health | Aetna is the brand name used for products and services provided by Allina Health and Aetna Insurance Company.

This material is for information only and is not an offer or invitation to contract. Health benefit plans contain exclusions and limitations. Providers are independent contractors and not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability are subject to change and may vary by location. If you are in a plan that requires the selection of a primary care physician and your primary care physician is part of an integrated delivery system or physician group, your primary care physician will generally refer you to specialists and hospitals that are part of the delivery system or physician group. Information is believed to be accurate as of the production date; however, it is subject to change.

*Applies only to covered services at MinuteClinic. Members in indemnity plans are not eligible for this benefit. Such members should refer to their benefit plan documents in order to determine coverage and applicable cost share for walk-in clinic benefits and services, as applicable. Visit MinuteClinic.com for age and service restrictions. Eligible members enrolled in qualified high-deductible plans must meet their deductible. However, such services would be subject to negotiated contract rates. Once the deductible has been met, members will be able to access MinuteClinic services at no cost share. 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. Aetna is not responsible for services received at MinuteClinic locations. 98point6 and 98point6 physicians are independent contractors and are neither agents nor employees of Allina Health | Aetna or plans administered by Allina Health | Aetna and does not guarantee that a prescription will be written.