Electronic connectivity

We will continually update this page as Aetna develops plans regarding the support and implementation of version 5010 HIPAA transaction standards. Please visit this page periodically for the most up-to-date information about our transition plan for the following transactions:
 

• Claim/Encounter (837) and Acknowledgements (277)
• Eligibility and Benefit Inquiry and Response (270/271)
• Claim Status Inquiry (276/277)
• Electronic Remittance Advice (835)
• Healthcare Services Review (278) Precertification and Referrals

Background:

On January 15, 2009, the U.S. Department of Health and Human Services (HHS) released a final rule that updated standards for electronic health care and pharmacy transactions.

The rule adopts updated versions of the standards governing electronic transactions under the authority of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The updated electronic transaction standards are implementations of ASC X12’s version 5010 and National Council for Prescription Drug Programs (NCPDP) version D.0 standards. View the HHS website for additional details.

Important Dates: 

January 1, 2011, Aetna plans to be ready to begin testing and production use of the new version transactions (ASC X12 version 5010 and NCPDP version D.0).

Until December 31, 2011, the final rule allows transactions use of either the previous version 4010A1, or the new version 5010.

January 1, 2012, Aetna plans to discontinue use of the previous versions (ASC X12 version 4010/4010A1 and NCPDP version 5.1). Only the updated standards (ASC X12 version 5010 and NCPDP version D.0) may be used.