ANSWER: Benefit payments can be viewed on the portal if Aetna is providing the payments.

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1 Can I documents to you? Documentation can only be submitted via fax or mail. Fax #: Mailing address: PO BOX Lexington, KY Can I see payment information on the portal? Benefit payments can be viewed on the portal if Aetna is providing the payments. To access payment information, click on the claim number and then click on PAYMENTS to view all payments associated with the claim. If payments cannot be viewed, it s possible that they have not been released for this claim or Aetna is not providing the payment. (Note: some companies are set up such that Aetna authorizes benefits and sends that information to the company for them to process the payments.) For more information, you can click on the link CONTACT AETNA ABOUT MY CLAIMS and send an . Why does it take so long to review my medical information? Claims are processed in the order the medical information is received. FMLA claims: A determination is generally made within 7-10 days from the date all required information is received. Part of the process may include confirming eligibility with the employer. Short Term Disability claims: A determination is generally made within 7-10 days from the date all necessary medical information is received. Part of the process may include confirming eligibility with the employer and having the medical information reviewed by a medical board/consultant.

2 Long Term Disability claims: A determination is generally made within 45 days from the date all necessary medical information is received. Part of process may include confirming eligibility with the employer, having the medical information reviewed by a medical board/consultant and a phone interview conducted by the Disability Benefits Manager and the employee. In all instances, you will be contacted by phone and mail when a determination is I have not been released to return to work yet. What do I need to do? Generally, if you have not returned to work, we will need updated medical information to have the claim reviewed for an extension. Usually, the notes from your last office visit will need to be received from the doctor to extend benefit authorization. In order to determine exactly what is needed, you can click on the link CONTACT AETNA ABOUT MY CLAIMS and send an . Please include the date of your last office visit and the date of your next scheduled office visit. I need to report that I had my baby. . Be sure to include the following information: Delivery date Type of delivery Number of babies delivered Date admitted to hospital Last day worked First day absent Any complications The Disability Benefits Manager will then contact you when the claim review has been completed. Your employer will also be notified.

3 I called and opened a claim last week for the surgery I am having next month, but I haven t heard back from Aetna yet? Aetna does not take actions or make determinations on claims that are for future dated procedures or surgeries. Once the procedure or surgery is completed and you begin missing work, Aetna will confirm with the attending physician, request supporting medical documentation and complete the review of the claim. if your procedure or surgery has been rescheduled. Now that I have opened the claim, what happens next? Once the claim is opened, it is assigned to a Disability Benefits Manager and a package is mailed to you with forms to complete. Generally, a medical form is faxed to the attending physician, if the physician s contact information was provided during the intake call. Please be advised a determination cannot be made on a claim without the receipt of medical information supporting the disability. The Disability Benefits Manager will then contact you when a determination is You can click on the link CONTACT AETNA ABOUT MY CLAIMS to send an to confirm if the medical forms have been faxed to the attending physician. I sent in all of my paperwork and I haven't heard anything from Aetna yet. to confirm if all paperwork has been received from your and your treating physician and to obtain a complete, updated status of your claim.

4 I called yesterday and was told that all the necessary medical information has been received. How long will it take to approve my claim? Claims are processed in the order the medical information is received. FML claims: A determination is generally made within 7-10 days from the date all required information is received. Part of the process may include confirming eligibility with the employer. Short Term Disability claims: A determination is generally made within 7-10 days from the date all necessary medical information is received. Part of the process may include confirming eligibility with the employer and having the medical information reviewed by a medical board/consultant. Long Term Disability claims: A determination is generally made within 45 days from the date all necessary medical information is received. Part of process may include confirming eligibility with the employer, having the medical information reviewed by a medical board/consultant and a phone interview conducted by the Disability Benefits Manager and the employee. In all instances, you will be contacted by phone and mail when a determination is I received a phone call message saying I was approved. What happens next? APPROVAL DATES Approval dates can be viewed on the portal. To view approval dates, click on the claim number, then look under the Claim Details tab. The APPROVED START DATE and APPROVED THROUGH DATE are listed. BENEFIT PAYMENTS Benefit payments can be viewed on the portal if Aetna is providing the payment. To access payment information, click on the claim number. Click on PAYMENTS to view all payments associated with the claim. If payments cannot be viewed, it s possible that they have not been released for this claim or Aetna is not providing the payment. (Note: some companies are set up such that Aetna authorizes benefits and sends that information to the company for them to process the payments.) For more information, you can click on the link CONTACT AETNA ABOUT MY CLAIMS and send an .

5 APPROVAL LETTERS Approval letters can also be viewed on the portal. To view an approval letter, click on LETTERS then click select to view the approval letter. The approval letter gives specific instructions if you are not planning on returning to work the day after the APPROVED THROUGH DATE. I got a phone call message saying I was denied. What happens now? Denial letters can be viewed on the portal. To view a denial letter, click on LETTERS then click select to view the denial letter. The denial letter provides information on what you can do if you do not agree with the denial. For more information about denied claims, you can click on the link CONTACT AETNA ABOUT MY CLAIMS and send an . I stopped receiving checks from Aetna but I am still out of work. What do I do? You can click on the link CONTACT AETNA ABOUT MY CLAIMS and send an to obtain a complete explanation of your claim status.