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We’re making it more convenient to obtain basic claims status/inquiries

 

We have provided self-service tools that allow providers and their representatives to pull basic claim status at their own convenience. Starting April 1, 2020, we will guide providers to use the Aetna Voice Advantage or our provider portal for basic claim status/inquires. We will continue to assist and service claim issues and more complex questions.

 

What is the difference between basic claim status/inquiry and claim issues?

 

Basic claim status/inquiry

Claim issues

When did the claim pay?

 

What is the EFT number?

 

Why did line ___ not pay?

 

How much did the claim pay?

 

I didn’t get my EOB on this, can you tell me how it paid? 

 

I was expecting more of a payment. Can you tell me how my payment was calculated?

 

What if I don’t agree with how the claim was paid/denied?

 

Can you tell me what information is being requested?

 

 

Need access to the provider portal?

Why is this change happening?

Providing exceptional service to our members and participating providers is very important to us. To this end, we are always looking to deliver more efficient solutions to meet your needs. This change will allow for shorter wait times and less time waiting for a response to your written claim status requests.