Claims, Payment & Reimbursement
Convenient tools and guidelines to help you get paid faster
How to submit a claim
Submitting your claims electronically is quick, convenient and easy. Choose the option that works best for you.
Tools that save you time and money
ERAs, EFTs and electronic EOBs
Receive payments directly to your account. And review claims payment information online any time.
Coordination of benefits
Get timely payments with electronic coordination of benefits (COB) when a patient is covered under more than one insurance plan.
Electronic transaction tools
Check eligibility and claims status. And send precertifications and referrals.
Payment estimator & fee schedule
Estimate how much your patients will owe for an office visit. Or look up how much we reimburse for services.
Digital member ID cards
Instead of a plastic ID card, your patients may give your office:
- Photocopy or printed version of ID card
- Electronic version of ID card, shown on a smartphone or tablet
Please accept these alternate formats. You can get a patient's digital member ID card by submitting an eligibility inquiry on our secure provider website, or through Availity. ID cards can be saved and printed.
Electronic solutions for lower costs
Electronic transactions can save you time. They also cost less than manual ones.
Out-of-network benefits
Some of our plans pay for services from doctors who are not in our network. We pay based on “usual and customary charges.”
Refunding overpayments
Whether we notify you about an overpayment or your office identifies it, we provide simple steps to refunding.
Aetna Signature Administrators
Aetna Signature Administrators (ASA) enables us to extend our services to additional plan sponsors with PPO plans