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Claims

Providers can file claims with Aetna Better Health® of California online or through the mail. Aetna Better Health of California works to streamline processing. And improve payment turnaround time, so you can save time and effort.

You can submit a claim:

Online

Aetna provider smiles and looks out window after filing claim on her ipad

Online

You can submit claims online or resubmissions through WebConnect. This is our free provider claims submission portal via Change Healthcare (formerly known as Emdeon). To register, please click the link below and follow the prompts to “Enroll New Customer.”

By mail

By mail

You can also mail hard copy claims or resubmissions to:

 

Aetna Better Health of California

Claims and Resubmissions

PO Box 66125

Phoenix, AZ 85082-6125

 

Resubmitted claims should have “resubmission” marked clearly on the claim form to avoid being denied as a duplicate.

Aetna provider helps patient fill out claims form

How do I file a claim?

Aetna provider helping expecting mother

How do I file a claim?

First, you need to fill out a claim form. If you are resubmitting a claim, you need to write “resubmission” on the paper claim form. You must file claims within 180 days from the date services were performed, unless there’s a contractual exception. For inpatient claims, the date of service refers to the member’s discharge date. You have 90 days from the paid date to resubmit a revised version of a processed claim.

Electronic funds transfer (EFT)

EFT makes it possible for us to deposit electronic payments directly into your bank account. You can get an EFT form here or on our Provider Portal. Some of the benefits of setting up an EFT include:

 

  • Improved payment consistency
  • Fast, accurate and secure transactions
  • Payments sent directly into your bank account

Electronic remittance advice (ERA)

ERA refers to an electronic file that contains claim payment and remittance information sent to your office. Sometimes, we’ll refer to ERA by its HIPAA transaction number: 835. You can find an ERA form here or on our Provider Portal. The benefits of an ERA include:

 

  • Reduced manual posting of claim payment information, which saves you time and money, allowing you to more efficiently manage your resources
  • Elimination of the need for paper Explanation of Benefits (EOB) statements

How can I resubmit a claim?

 A claim may be resubmitted if it was denied or incorrectly paid due to missing documentation or another processing error. You must clearly write “resubmission” and mail it with the following:

 

  • 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 the claim was denied or incorrectly paid
  • A brief note describing the requested correction
  • Any additional required documentation

 

If you are resubmitting through the WebConnect portal, you will need to identify your resubmission with a “7” in the indicator field. When submitting claims to our plan, use the provider ID number "128CA" for both CMS-1500 and UB-04 forms. You can easily request to have a dispute resolved. You just have to follow the instructions on our dispute resolution form and mail it to us. You can learn more about this process on our “Provider grievances and appeals” page.

Questions about claims or electronic billing?

Call Provider Services at
1-855-772-9076 (TTY: 711).