Claims

You can file claims with us electronically or through the mail. We work to streamline the way we process claims. And improve payment turnaround time, so you can save time and effort.

Questions?

You can check your provider manual. Or contact us.

Fee schedules and billing codes

You can find the billing codes you need for specific services in the fee schedules.

Fee schedule

You’ll need to fill out a claim form.

You must file new claims within 365 days from the date you provided services, unless there’s a contractual exception. For hospital inpatient claims, the date of service refers to the date that the member was discharged.

Some timeframes to note:

Medicaid: You have 180 days from the paid date to resubmit a revised version of a processed claim.
Medicare-Medicaid (Aetna Better Health® Premier Plan): You have one year from the date of service or discharge to resubmit a revised version of a processed claim.

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:

Medicaid:

Aetna Better Health® of Michigan

PO Box 982863

El Paso, TX 79998-2963

Medicare-Medicaid (Aetna Better Health Premier Plan):

Aetna Better Health of Michigan

PO Box 982963

El Paso, TX 79998-2963

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 submit by mail, you’ll need to include these documents:

Claim reconsideration and dispute form
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

Mark submission clearly with “reconsideration” or “corrected claim.”

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 contact us.