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Electronic claims

Submit electronic claims and get paid faster

Submit electronic claims and get paid faster

Want to get paid faster? You can submit medical claims in one of three ways:

National Provider Identifier (NPI)

The National Provider Identifier (NPI) improves the efficiency and effectiveness of the electronic transmission of health information. It replaces many numbers you may have previously supplied to payers on electronic claims, certifications and authorization transactions. This includes Medicare and Medicaid numbers, and other payer numbers.

Clinical records

We may ask you to submit clinical records before we pay a claim if the claim includes:

 

  • A code appended with Modifier 22 (unusual procedural service). For example, we may request an operative report for surgical procedures or office notes for non• surgical procedures.
  • An "unlisted code" as defined in the Index of CPT Codes under "unlisted services and procedures."
  • A code from our list of non-specific codes.

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Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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