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Common Denial Reasons How to File an Appeal Step 1: Review Your Denial Letter Understand the specific reason for denial Note the deadline for filing an appeal (usually 60-180 days) Step 2: Gather Supporting Documents Complete medical records All imaging reports Records of every treatment tried Letter from your doctor explaining medical necessity Step 3: Submit Your Appeal Mail or fax to the address on your denial letter Include a clear explanation of why you believe coverage should be approved Attach all supporting documents Step 4: Request Peer-to-Peer Review Your doctor can speak directly with an Aetna medical director This often resolves issues faster than written appeals Step 5: External Review (If Needed) If Aetna denies your internal appeals, you can request an independent external review Contact your state insurance commissioner if you need additional help Tips for a Successful Appeal Key Takeaways Aetna Coverage Summary What Aetna covers: Hyaluronic acid injections (with precertification) Cortisone shots Physical therapy What you need for approval: Imaging confirming osteoarthritis 3+ months of failed conservative treatment Documentation of pain and functional limitation What to do next: Call Aetna member services to verify your specific benefits Confirm your provider is in-network Make sure precertification is obtained before treatment Keep records of all treatments you have tried Appeal if denied (many denials are overturned) Find Providers Who Accept Aetna Locate in-network specialists who can help with knee injections and joint pain treatment

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