wantzuloo.blogg.se - Aetna timely filing

#AETNA TIMELY FILING PROFESSIONAL#

We can’t accept COB reconsiderations via electronic transmission.

Process and decide COB claim reconsiderations within 95 days from the disposition date on the primary carrier’s EOB or response letter.

Identify a Coordination of Benefit (COB) resubmission as a claim previously denied for other insurance info, or originally paid as primary without coordination of benefits.

Process and decide claim reconsiderations within 120 days of the resolution date on the original (clean) claim’s EOB.

#AETNA TIMELY FILING PROFESSIONAL#

Processing clean payments for professional and institutional claim submissions.Process and decide claims within 30 days of receipt - This includes:.Any information that the health plan previously requested.A copy of the remit/Explanation of Benefits (EOB) page for each resubmitted claim, with a brief note about each claim you’re resubmitting.A claim adjustment request/claim reconsideration form (PDF) for each reconsideration.When you send a reconsideration, be sure to include: Mark resubmitted claims clearly with “resubmission” to avoid denial as a duplicate. You can also mail hard copy claims or resubmissions to: Once you’ve submitted claims, you can visit the Provider Portal to review claims payment information. To register, visit the ConnectCenter portal and follow the prompts to “Enroll New Customer.” This is our provider claims submission portal via Change Healthcare (formerly known as Emdeon). You can submit claims or resubmissions online through ConnectCenter.

You have 180 days from the paid date to resubmit a revised version of a processed claim. Since Medicare automatically routes secondary claims to us, 96 of those paper claims turn out to be unnecessary duplicates. For inpatient claims, the date of service refers to the member’s discharge date. Some interesting claim submission facts: On average, Aetna Senior Supplemental Insurance receives 60,000 paper claims each month. You must file claims within 180 days of the date you provided services, unless there’s a contractual exception.