Aetna 3rd-Party Claim and Code Review

Beginning June 1, 2022, you may see new claim edits.

According to March 1, 2022 Aetna OfficeLink Updates: These are part of our Third-Party Claim and Code Review Program. These edits support our continuing effort to process claims accurately for our commercial, Medicare and Student Health members. You can view these edits on our Availity provider portal.*

You can view any of these edits on Aetna’s Availity® provider portal.

For coding changes, go to:

  • Aetna Payer Space
  • Resources
  • Expanded Claim Edits

Except for Student Health, you’ll also have access to Aetna’s code edit lookup tools. To find out if our new claim edits will apply to your claim, log in to our Availity provider portal. You’ll need to know your Aetna® provider ID number (PIN) to access our code edit lookup tools

Here is what POET found with 2022 effective dates:

Author: Seymore Bones

Leave a Reply