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Medical - HIPAA Standards
- HIPAA Electronic Transactions and Code Sets Q&A
(6 pages)
- Aetna's Timeline for HIPAA Transactions Testing and Implementations
- Physicians News Article - "Aetna is Implementing Electronic Transaction Standards In Compliance with HIPAA Requirements" (1 page)
- Testing Your HIPAA Compliant Transactions With Aetna's Contracted Clearinghouses:
Aetna has done extensive testing of the HIPAA electronic transactions with our clearinghouse partners. View Aetna Electronic Transaction Flow (1 page). To test your electronic transactions, it is imperative that providers work with their vendor(s) and clearinghouse(s). Review the list of Aetna clearinghouse partners.
- Eligibility Inquiry & Response (270/271), Claim Status Inquiry (276/277), and Referral/Pre-certification Request and Response (278) - Providers that wish to test these real-time transactions may obtain test ids and scenarios from our contracted clearinghouses. Upon submission of a test real-time transaction, providers will receive a comprehensive response from Aetna's contracted clearinghouses.
- Claim Submission (837) - Providers and vendors should contact their clearinghouse to arrange testing of claim submissions to Aetna. Aetna has provided (and will update as necessary) its contracted clearinghouses with all the information they need to successfully transmit HIPAA-compliant transactions through to us. Providers should contact the clearinghouses to determine whether the clearinghouses have specific suggestions or guidance related to the submission of claims.
- Claim Payment (835) - For a limited time, providers that elect to receive an Electronic Remittance Advice (ERAs) in the Claim Payment (835) transaction format have the option to continue to receive paper remittance advices for comparison.
Contact Us for further instruction, information and/or questions regarding testing.
