UM/Aetna medical plan members may contact UM’s on-campus Aetna claims representative for assistance with billing and claims issues at 305-284-3004.  If you receive a bill for covered services from an Aetna provider you must do the following:

In-Network
1. Make a copy of your Aetna ID card (front and back) and a copy of the bill. Send a copy of both to the provider who is sending you the bill. This will alert the provider to bill the insurance company. Provide an explanation of the issue.

2. Follow the same steps as above, but mail the information to the Aetna claims address on the back of your ID card. Provide an explanation of the issue.

Out-of-Network
1. Complete the claim form located at www.miami.edu/benefits/forms.

2. Send Aetna a copy of your Aetna ID card and a copy of the itemized bill. When filing a claim you will need to provide: member ID, billed charges, patient date of birth, procedure code(s), diagnosis code(s), provider name and address or tax ID, and indicate on the bill if the charges were paid.

Note: If you would like assistance with regard to medical claims issues from a University benefits representative, you must first complete the online HIPAA authorization.  The Health Insurance   Portability and Accountability Act (HIPAA) provides rights and protections for participants and beneficiaries in group health plans. HIPAA includes protections for coverage under group health plans that limit exclusions for preexisting conditions and prohibit discrimination against employees and dependents based on their health status. To complete the authorization, log on to www.miami.edu/myUM, click “Employee”, then “Benefits,” under the center “Benefits” column, select “HIPAA Authorization.”