Participants in the Aetna U.S. Healthcare HMO and QPOS plans have until Sept. 26 to appeal denied claims under an agreement between the New York State Insurance Dept. and the insurance carrier.

Earlier this year, the Insurance Department fined Aetna $1.5 million because it failed to notify participants about their right to appeal when the company refused to cover medical treatment. An estimated 8,000 DC 37 members - municipal employees and state workers - are enrolled in the Aetna plan.

Under the agreement between the Insurance Dept. and Aetna, participants will be able to appeal for the first time or submit new appeals for any coverage that was denied from July 1, 1994 to July 31, 2001.

The agreement also lets participants appeal claims that were partially or fully denied between Jan. 1, 2000 and Sept. 30, 2001 and resubmit appeals that were denied.

For more information on the appeals process, call 1-888-305-7649.

New claims must be submitted in writing to New York Claims Appeals, c/o Aetna, 151 Farmington Ave., Hartford, CT 06156-7206.

To resubmit a denied appeal, write New York Claims Reconsideration, c/o Aetna, 151 Farmington Ave., Hartford, CT 06156-7208.

Requests for claims reconsideration may be made over the phone (1-888-305-7649).

Written requests for claims reconsideration and appeals must include either a copy of the explanation of benefits form or the participant's Aetna ID number, the patient's name, the date the services were rendered and the name of the health care provider. The requests must also include any other relevant information, such as the bill, physician statements, medical records, paid receipts or canceled checks.