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Electronic Remittance Advice (ERA)

Electronic Remittance Advice (ERA) aetna is the brand name used for products and services provided by one or more of the aetna group of companies. ( aetna ) KR-0302-12 aetna Provider eSolutionsSM Overpayment Recovery Codes When overpayment recovery is initiated from a provider who has ERA, specific adjustment codes are used to indicate the reason for adjusting the provider payment amount in the ERA. The following codes apply to ERAs generated for claims processed on aetna s strategic claim system ( aetna Claim Adjudication System, or ACAS). Overpayment Details by ERA For most claims, claim details are sent in the ERA via reversals and corrections at the time overpayment recovery is initiated. When overpayment on a claim is due to considering a prior related claim, overpayment recovery is initiated immediately and the ERA carries claim details. When overpayment on a claim is due to a reason other than considering a prior related claim, claim details are sent via letter immediately but overpayment recovery initiation is delayed for the length of time specified by state regulations or contract requirements.

Electronic Remittance Advice (ERA) Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies. (Aetna) KR-0302-12 If the amount being recovered is different from the original payment amount, a payment level adjustment will be created using a …

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