Announcements and news

In this ever changing world of health care, you as a provider need to stay on top of the latest news in our industry.  Aetna Better Health of West Virginia helps you with this and takes the lead.  We provide you with news and updates from us, as well as the latest breaking stories from the health care industry as a whole.  From these pages you will see real time feeds from newsmakers like Centers for Medicare and Medicaid Services (CMS), Centers for Disease Control (CDC), and others. We know that you want to stay informed, and here at Aetna Better Health, we give you the tools to do so.

Effective September 15, 2017, providers have a new resource for making Peer to Peer Requests for Aetna Better Health of WV. Please call 1-866-389-1667 to contact our Health Services/Medical Management Department directly with your request.

Aetna Better Health of WV regularly reviews and analyzes claim composition to identify opportunities for improvement. To that end, we are working with Cotiviti Healthcare (Cotiviti) to assist us with provider claim reviews and reimbursement review practices. Cotiviti performs reviews of medical records for services rendered and conducts post payment reviews of medical claims.

As a provider for Aetna Better Health of WV, you may receive communication from Cotiviti requesting additional information or sharing our findings pertaining to those reviews. 

Questions?
If you have any questions about this review process, simply call Aetna Better Health of WV’s Provider Relations Department at 1-888-348-2922. You can reach us Monday through Friday, 8 a.m. to 5 p.m.

Critical Care Limits

Required Information for Requested Drug Screening Tests

  1. Amount of code units completed
  2. Amount of code units being requested
  3. Eight current weeks of drug screening test results
  4. Eight current weeks of therapist and physician treatment notes