Medical and Dental Claim Appeal Instructions
New appeal regulations were implemented by DRB on January 1, 2018. RPEA has written instructions on how you can best use them to file an appeal concerning any dispute you have with AETNA or Moda regarding your medical or dental bills. Note that we have separated Dental from Medical, Audio and Vision coverage. The new instructions are to be used only for appeals filed after January 1, 2018. For appeals filed prior to January 1, 2018, use the previous instructions found below.
For appeals dated January 1, 2018 or later
- Medical-Vision-Audio Appeal Process Instructions
- Dental Appeal Process Instructions
- New Appeal Process Flowchart - a diagram of appeal steps
RPEA has developed these appeal instructions in an effort to help retirees better understand the appeals procedures recently imposed by DRB under the AlaskaCare Retiree Health Plan. These instructions are not intended to provide any sort of legal advice or direction. Each retiree should read the new 2018 appeals procedure adopted by DRB which govern any appeal submitted. These instructions are meant to make that new appeal procedure more understandable but should not be viewed or used as the actual appeal procedure. Each retiree must understand that use of these instructions are to assist only but not control any particular appeal filed.
Note: when viewing the flowchart in a browser, use the enlarge button [+] for easier reading. Or, save the pdf file to a computer and open it with Adobe Acrobat or Acrobat Reader to enlarge the text.
For appeals dated PRIOR to January 1, 2018
Recommended Cover Page Language