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Overview | Out-Patient Procedure | In-Patient Procedure | Outreach Procedure | Claim Forms

Prepaid Claim That Needs AETNA's Reimbursement
You have paid for your treatment bills and now to get AETNA to reimburse you.
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Treatment That Needs AETNA's Pre-Authorization/Direct Settlement (outside USA)
You are seeking treatment outside USA and need Aetna to provide Pre-Authorization or Direct Settlement.
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Treatment Within AETNA's Preferred Provider Network In The USA
This section is for getting your treatment in USA.
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Note
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General Claims Information
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Complaints
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Prepaid Claim That Needs AETNA's Reimbursement


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Treatment That Needs AETNA's Pre-Authorization/Direct Settlement (outside USA)


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For treatment outside the USA, our members are free to seek treatment from any service provider of their choice. If their eligible day patient or inpatient treatment is at a service provider that is part of Aetna's network, the service provider will be able to accept Aetna's direct settlement arrangement. For info on the service providers in your country of treatment that are part of Aetna's network, please write to info@talent-trust.com
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Treatment Within AETNA's Preferred Provider Network In The USA


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Aetna is able to arrange direct-settlement for eligible outpatient, day patient and inpatient treatment within Aetna's network of service providers in the USA.

You can find the Provider Network facilities in the USA by Clicking Here for the link to this info or you may call Aetna International Service Centre at their number +1 877 248 2197 (as printed on the membership card or the Schedule of Cover) for their assistance.
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Note
  1. Should you have any difficulties with your claim submission or claim process, please contact us and the TTc team will be happy to assist you.

  2. Should a member under our long-term program, i.e., Alpha or Omega, make a claim and receive reimbursement, their NCB discount will revert to a level two years below their current level at their next renewal. However, if the reimbursement exceeds US$10,000 (for claims within the USA) or US$25,000 (for claims outside the USA), the NCB discount will drop all the way down to the standard premium, i.e., no discount.
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General Claims Information


  1. We reserve the right to reject any claim which is not submitted within 90 days of the date of treatment. All documents and materials (including, but not limited to original accounts, certificates and x-rays) that we require to support a claim, shall be provided without expense to us (including, if requested by us, a medical report from your medical practitioner or specialist and details of your medical history).

  2. In cases where medical information is required by us for consideration of a claim, but it is not made available to us, it is your responsibility to obtain such information from your current or previous medical practitioner, as appropriate. Claims may only be made for treatment actually given during a Period of Cover and benefit will be available only for expenditure incurred prior to expiry or termination of such cover.

  3. An insured person must, without delay, give us written notification of any claim or right of action against any third party arising out of circumstances which gave rise to a claim under this policy and must continue to keep us fully informed in writing and take all steps we reasonably require in making a claim upon that other party. We shall be entitled to take legal action in any insured person's name for our own benefit and claim for indemnity or damages or otherwise which relates to any benefits and costs paid or payable under this policy. We shall have full discretion in the conduct of any such proceedings and in the settlement of any such claim.

If You have any questions concerning the above or any other aspect of your policy please do not hesitate to contact your local Aetna claims office.
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Complaints


Our aim is at all times to provide a first-class standard of service. However, there may be occasions when you feel that this objective has not been achieved. Should you have any complaint please contact us.
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