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Third Party Claim and Code Review Program


Accurate claims processing with our Third Party Claim and Code Review Program
 

Beginning December 1, 2020, you may see new claim edits. These are part of our Third Party Claim and Code Review Program. These edits support our continuing effort to process claims accurately. You can view these edits on our provider website.  


You'll have access to our prospective claims editing disclosure tool. To find out if our new claim edits will apply to your claim, log in to the provider portal. Then go to Aetna Payer Spaces > Applications > Code Edit Lookup Tools. You'll need to know your Aetna® Provider ID Number (PIN) to access. Note: This is subject to regulatory review and separate notification in Washington state.