Another group or vendor provides the info on the next page. If you don’t want to leave our site, choose the “X” in the upper right corner to close this message. Or choose “Go on” to move forward.
Questions?
You can check your provider manual (PDF). Or call Provider Relations at 1-855-456-9126 (TTY: 711). We’re here for you Monday through Friday, 9 AM to 5 PM.
Fee schedules and billing codes
You can find the billing codes you need for specific services in the fee schedules.
Home care and social day care providers need to submit all claims on UB 04. If a participating provider does not submit appropriately, claims may be delayed or denied.
You’ll need to fill out a claim form.
You must file claims within 120 days from the date you provided services, unless there’s a contractual exception.
Online
You can submit claims or resubmissions online through ConnectCenter. This is our provider claims submission portal via Change Healthcare (formerly known as Emdeon). To register, visit the ConnectCenter portal and follow the prompts to “Enroll New Customer.”
ConnectCenter portal
ConnectCenter user guide (PDF)
Once you’ve submitted claims, you can visit the Provider Portal to review claims payment information.
Change Healthcare
ChangeHealthcare.com
1-866-371-9066
By mail
You can also mail hard copy claims or resubmissions to:
Aetna Better Health Claims
PO Box 982972
El Paso, TX 79998-2972
Mark resubmitted claims clearly with “resubmission” to avoid denial as a duplicate.
You can resubmit a claim through ConnectCenter or by mail. If you resubmit through the ConnectCenter portal, you’ll need to mark your resubmission with a "7” in the indicator field.
If you resubmit by mail, you’ll need to include these documents:
An updated copy of the claim — all lines must be rebilled
A copy of the original claim (reprint or copy is acceptable)
A copy of the remittance advice on which we denied or incorrectly paid the claim
A brief note describing the requested correction
Any other required documents
Both in-network and out-of-network providers have the right to dispute the result of a decision. You’ll want to file your dispute in writing within 60 calendar days of the reconsideration response (date of EOB).
You'll get a final determination letter with the decision, rationale and date of the decision. We usually resolve provider disputes within 30 calendar days.
If the decision of the dispute isn’t in your favor, you can’t “balance bill” the member for services or payment that we denied for coverage.
You can dispute a claim:
By mail
You can send your dispute to:
Aetna Better Health of NY - Provider Relations Department
Attention: Provider Dispute
101 Park Ave, 15th Floor
New York, NY 10178
By fax
Fax your dispute to 1-855-264-3822 or 1-860-754-9121.
If for any reason you are not satisfied with our policies, procedures or any aspect of our administrative functions, you may file a complaint. You can learn more about the complaints process on our complaints and appeals page.
Learn more about complaints
EFT/ERA Registration Services (EERS)
EERS offers our providers a more streamlined way to access payment services. It gives you a standardized method of electronic payment and remittance while also expediting the payee enrollment and verification process. Using the Change Healthcare tool, you can manage electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollments with multiple payers on a single platform.
EFT makes it possible for us to deposit electronic payments directly into your bank account. Some benefits of setting up an EFT include:
Improved payment consistency
Fast, accurate and secure transactions
ERA is an electronic file that contains claim payment and remittance info sent to your office. The benefits of an ERA include:
Reduced manual posting of claim payment info, which saves you time and money, while improving efficiency
No need for paper Explanation of Benefits (EOB) statements
EERS offers payees multiple ways to set up EFT and ERA in order to receive transactions from multiple payers. If a provider’s tax identification number (TIN) is active in multiple states, a single registration will auto-enroll the payee for multiple payers. You can also complete registration using a national provider identifier (NPI) for payment across multiple accounts.
Registering for EERS enrollment
If you currently use Change Healthcare as a clearinghouse, you’ll still need to register for EERS enrollment. If you currently have an application pending with Change Healthcare, you won’t need to resubmit. Once you’re enrolled, you can use the Change Healthcare user guide to help you navigate the new system.
To enroll in EERS, you can visit Change Healthcare Payer Enrollment Services.
Questions? Just visit the Change Healthcare FAQs page. Or call Provider Relations at 1-855-456-9126 (TTY: 711).