Payer Sheet - Aetna

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Aetna Payer Sheet Commercial Primary 06/04/2018 Page 2 of 24 Table of Contents HIGHLIGHTS Updates, Changes & Reminders ........................................ .............. 3 PART 1: GENERAL INFORMATION ........................................ ................................... 4 Pharmacy Help Desk Information ........................................ ............................... 4 PART 2: BILLING TRANSACTION / SEGMENTS AND FIELDS ........................... 5 PART 3: REVERSAL TRANSACTION ........................................ .............................. 12 PART 4: PAID (OR DUPLICATE OF PAID) RESPONSE ...................................... 13 PART 5: REJECT RESPONSE ........................................ ........................................ .. 18 APPENDIX A: BIN / PCN COMBINATIONS ........................................ ..................... 22 Primary BIN and PCN Values.

10/31/2017 Page 3 of 24 HIGHLIGHTS – Updates, Changes & Reminders This payer sheet refers to Primary Commercial Primary Billing and Medicare as Secondary Payer …

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