Provider Directory Database Update 5/18/2017

Aetna Better Health of Illinois is dedicated to providing our members with accurate and up to date information about the providers we list in our online directory database. This quick survey will allow us to ensure that our directory information is current so that our members are able to get the care that they are seeking in a timely manner. We appreciate you taking the time to check our provider directory, and provide any updates or changes to the information.  Please click the following link for the survey.

Long Term Care Facility Billing Changes

Aetna Better Health is in the process of updating our payment systems to be compliant with the 12-1-2016 Long Term Care Facility Billing Changes set forth by HFS. Providers should continue to bill claims with the appropriate billing instructions consistent with the date of service.  Please click here for more information.

Weekend Utilization Management Policy

We are writing to inform you of a policy change related to our "Weekend Utilization Management Policy" that was implemented in July 2016. Aetna Better Health of Illinois has heard your feedback and we are adjusting the policy based on your suggestions. Click here for more information on this policy.

Updating the Provider Directory Survey

As part of our ongoing effort to report accurate and complete information in our directory, your office was identified as missing hours of operation information. This information is required by CMS and the Illinois Department of Healthcare and Family Services for each provider in our directory.  We are requesting that you take a moment to provide this information for your location(s). 

  • Fill out the survey for your locations, indicating your office details and the hours of operation.

General Acute Care and Children’s Billing Guidelines 11/10/2016

General Acute Care and Childrens Hospital Billing Guidelines

The Illinois Department of Healthcare and Family Services (HFS) requires Managed Care Organizations (MCO) to meet very specific claim data submission standards requiring particular and exact data elements on claims submitted from Hospitals. To facilitate the appropriate application of these rules, Managed Care Organizations are collectively relaying the enclosed information in this Provider Memorandum in an effort to reiterate and provide transparency on hospital billing guidelines for services rendered in a Children’s and General Acute Care Institutional setting.  Please click here to read the offical memorandum.

Click here for the General Acute Care and Children’s Billing Guidelines.

Medicare Prescriber Enrollment

Beginning 2/1/2017, Aetna Better Health will require prescribing providers to be either enrolled in Medicare fee-for-service or have a valid opt-out affidavit on file effective Feb 1st, 2017.  Starting on February 1st, 2017, MMAI members will obtain a provisional supply when filling prescriptions written by prescribers who do not meet the above requirement.

For additional information visit the CMS provider and supplier enrollment page.

Any additional information related to the above notice can be directed to the provider services at Aetna Better Health.