How to “manually” file a claim to Aetna

Hi friend,
I used to work at aetna in customer service and claims processing if that gives my advice any additional weight.
You have the right form.
Here's the easiest way to do it:
Fill out lines 1-25 don't sign 26, that sends payment to the doctor instead of you
leave the entire bottom section (under 'to be completed by physician or supplier') blank. Attach an itemized bill from the doctor and that's literally it. That bottom section is only required if the doctor wants to fill it out instead of providing a bill, which almost never happens. Honestly after seeing probably hundreds of thousands of claim forms, I can say 99.9% of the time the bottom is blank and there's a bill stapled to it or faxed along with it.
The doctor has to provide an itemized bill as a licensed practitioner upon request, so if what she is getting now is not detailed just have her asked for an itemized bill that she can file the claim to her out of network benefits on her own, that will have everything Aetna needs. Don't worry if it doesn't have codes, descriptions of the service and diagnosis are fine because Aetna's claims system translates them into codes down the line.
P.S. best way to send in the document once you have it? Old school FAX. Even though you will put all of her aetna information on the claim form, take a blank piece of paper and write in BIG BOLD TYPE: her name and her Aetna id number (starts with a 'w'), and Attention: CLAIMS. That's your cover sheet. fax it to 866-474-4040 (this fax number is seared into my brain for eternity). take note of the time you faxed it and the fax number you sent it FROM. Call aetna an hour later and have them look it up, and forward it to claims over the phone.
hope this helps