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Dispute & Appeals

Information to guide you

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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.

Learn more about the dispute process
View our dispute process quick reference guide

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Medicare appeals

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

Learn more about Medicare appeals

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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

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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

Together, better health

Inova and Aetna have partnered to transform the patient health care journey. Through integrated, coordinated team communication and innovative programs, our plans are personalized to fit your needs, at any stage. Discover how we help members achieve their health ambitions, right in their community.

Legal Notices & Privacy Policies

Health benefits and health insurance plans are offered and/or underwritten by Innovation Health Insurance Company and Innovation Health Plan, Inc. Innovation Health Insurance Company and Innovation Health Plan, Inc. are affiliates of Inova and of Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain management services to Innovation Health. Each insurer has sole financial responsibility for its own products.

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Links to various non-Innovation Health sites are provided for your convenience only. Innovation Health and Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.

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Innovation Health Insurance Company and Innovation Health Plan, Inc. (Innovation Health) are affiliates of Aetna Life Insurance Company (Aetna) and its affiliates. Aetna and its affiliates provide certain management services for Innovation Health.

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Notice:

Notice: Beginning 7/23/19 the Innovation Health member portal has changed to the new Aetna Health portal.  This system transition will not affect any member or plan information and can still be accessed through the member portal "Log In" button on innovationhealth.com.  This system transition is part of our ongoing goal to better serve our members and improve their experience.

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