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Claims

Providers can file claims with Aetna Better Health® of Maryland electronically or through the mail. Aetna Better Health of Maryland 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 or resubmissions online through WebConnect. This is our provider claims submission portal via Change Healthcare (formerly known as Emdeon). To register, just choose “WebConnect” below and follow the prompts to “Enroll New Customer.” Use 128MD for your payer ID.

By mail

By mail

You can also mail hard copy claims or resubmissions to:

 

Aetna Better Health of Maryland 
Claims and Resubmissions 
PO Box 61538 
Phoenix, AZ 85082-1538

 

Use 128MD for your payer ID. Resubmitted claims should have “resubmission” marked clearly on the claim form to avoid being denied as a duplicate. 

 

Download CMS-1500 (PDF)

 

Download UB-04 (PDF)

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. 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 60 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. 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 can be resubmitted through WebConnect or by mail. If you resubmit through the WebConnect portal, you’ll need to identify your resubmission with a "7” in the indicator field. If you choose to resubmit by mail, please include 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 

Provider payment disputes

You may file a payment dispute verbally or in writing. We can help resolve billing, payment and other administrative disputes for any reason, including, but not limited to:

 

  • Lost or incomplete claim forms or electronic submissions

  • Requests for more info about services or treatment by a health care provider  

  • Inappropriate or unapproved referrals by the provider

Provider payment disputes don’t include disputes related to medical necessity.

 

Just call 1-866-827-2710 (TTY: 711) to file a verbal dispute. 

 

To file a written dispute, submit a dispute form (PDF) with any supporting documentation to:

 

Aetna Better Health of Maryland 
Claims and Resubmissions 
PO Box 61538 
Phoenix, AZ 85082-1538

 

If the dispute is about claim resubmission or reconsideration, we may refer it to the Claims Inquiry Claims Research department. Then, we’ll notify you about the dispute resolution by phone, email, fax or mail.

 

If you’re not satisfied with the outcome of your dispute you can learn more about filing grievances and appeals

Questions?

You can call Provider Relations at 1-866-827-2710 (TTY: 711).