Claims transactions

 

Medical Claims

Submit your medical claims in one of three ways. You'll save time and money.  (PDF)

1. Free of charge through our secure provider website via NaviNet® 
2. Free of charge using EDI ConnectSM (for the technically savvy)
3. Through one of our electronic transaction vendors.

EDI Savings Calculator

If you’re looking for ways to reduce your practice’s expenses, consider doing business electronically. See how much you’ll save with our EDI Savings Calculator. 

 

You can also:

Check the status of claims  (PDF) electronically.
Send secondary (COB) claims electronically.

Dental Claims 
Submit your dental claims electronically. For your convenience, download an Aetna Dental claim form.  (PDF)

Pharmacy Claims
Submit your pharmacy claims electronically. 

Behavioral and mental health claims
Submit your behavioral health claims electronically. 

Claims for hospitals and other facilities
Submit your claims for medical facilities electronically in one of three ways:
1. Free of charge through our secure provider website via NaviNet® 
2. Using EDIConnectSM (for the technically savvy)
3. Through some of our clearinghouse vendors 

National Provider Identifier (NPI)
One provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was the adoption of unique identifiers for health care providers and health plans. This is called the National Provider Identifier (NPI). The purpose is to improve the efficiency and effectiveness of the electronic transmission of health information. The NPI replaces many different numbers (Medicare and Medicaid numbers, and other payer numbers) you currently supply to your payers on electronic claims, certifications and authorization transactions.

If you need an NPI, go here.

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