Understanding electronic claims submission - Aetna

1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Understanding electronic claims submission Enter the member ID number exactly as it appears on the If necessary, use the following claims billing ID card. Do not include any dashes, suffixes or spaces. addresses Review reports promptly to identify any items that require If your practice management system requires you to enter attention. a billing address, use the address listed below for the state Correct rejected claims and resubmit electronically. in which you practice: All providers, both participating and nonparticipating, can submit claims electronically regardless of patient's State Address benefits plan . AL, AK, AR, AZ, CA, FL, GA, HI, ID, Aetna LA, MS, NC, NM, NV, OR, SC, UT, PO Box 14079. Avoid the additional cost of submitting duplicate claims by TN, WA Lexington, KY.

2 Using the claim Status Inquiry to check the status of claims 40512-4079. prior to resubmitting. Attachments aren't necessary. We'll contact you if we need State Address additional documentation. CO, CT, DC, DE, IA, IL, IN, KS, KY, Aetna For questions on how to submit electronic claims to third-party MA, MD, ME, MI, MN, MO, MT, NE, PO Box 981106. administrators, such as an individual practice association, ND, NH, NJ, NY, OH, OK, PA, RI, SD, El Paso, TX. contact the third-party administrator. TX, VA, VT, WI, WV, WY 79998-1106. Aetna Student HealthSM. PO Box 15708. Boston, MA 02215-0014. Payer ID 60054. Affordable HealthChoices from Aetna . SRC, an Aetna company PO Box 14079. Lexington, KY 40512-4079. Payer ID 57604. B (5/13). Requirements to submit Coordination of Benefits Where to turn for help (COB) claims electronically Depending on your situation, you have a variety of resources to To submit COB claims electronically, your practice management help you find the answers you're looking for: system and your vendor must be able to: If your claim rejects at the vendor level, contact your vendor.

3 Create or forward claims in the full HIPAA standard format If you have questions regarding the status of a claim (for (837) or in a format that contains equivalent information and instance, whether it has been paid or processed), use our includes necessary COB fields. claim Status Inquiry transaction. Include payment information received from the primary For claims that have completed the payment process, you may payer's HIPAA standard electronic remittance advice (ERA) retrieve supplemental claims information, such as copayment or convert the primary payer's payment information received or coinsurance amounts or negotiated fee adjustments, using on an Explanation of Benefits (EOB) into standard coding the financial status transaction.*. used in an ERA. Need more help with electronic claims submissions ? Use the To learn more about submitting COB claims electronically, go to Contact Us link on our website at Or, call your vendor's customer service help line.

4 *Availability varies by vendor. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies ( Aetna ). 2013 Aetna Inc. B (5/13).