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Claims
You can file claims with Aetna Assure Premier Plus (HMO D-SNP) online or through the mail. We do our best to streamline processing. And improve payment turnaround time so you can save time and effort.
You can submit a claim:
Online
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 site” below and follow the prompts to “Enroll New Customer.”
You can also mail hard copy claims or resubmissions to:
Aetna Assure Premier Plus (HMO-DSNP)
Claims and Resubmissions
PO Box 982967
El Paso, TX 79998-2967
ConnectCenter
ConnectCenter
Change Healthcare has produced and made available the Getting Started with the Sign-Up process guide (PDF) guide to assist in general navigation and registration with ConnectCenter powered by Change Healthcare office.
Please review the guides below for verifying member eligibility and claim submissions.
Getting Started with Eligibility in Connect Center (PDF)
Getting Started with Provider Management in Connect Center (PDF)
Getting Started with Claims in ConnectCenter (PDF)
Uploading a Claim in ConnectCenter (PDF)
Keying Professional Claims in ConnectCenter (PDF)
Keying Institutional Claims in ConnectCenter (PDF)
Obtaining a Claim status in ConnectCenter (PDF)
How do I file a claim?
How do I file a claim?
Aetna Assure Premier Plus (HMO D-SNP) encourages providers to electronically submit claims, through Change Healthcare. You will need to fill out one of the claim forms. You will want to use ID # 46320 as the Submitter (Payer) ID on both forms.
You’ll want to use this Submitter ID number when you submit claims: Payer ID# 46320 for both CMS-1500 (PDF) and UB-04 (PDF) forms.
Check the policies and procedures in the provider manual (PDF) if you’re an out-of-network provider seeking payment of claims for services we cover for providers who are non-participating, such as:
The plan covers emergency care or urgently needed services from an out-of-network provider
If a member needs to seek medical care and there are no providers in the network that can provide care, members can see a non-participating provider with a prior authorization
The plan covers kidney dialysis services that are at a Medicare Certified dialysis facility when the member is temporarily outside the plan’s service area with a prior authorization
EFT/ERA registration services (EERS)
Aetna Assure Premier Plus has partnered with Change Healthcare to introduce the EFT/ERA Registration Services (EERS), a better and more streamlined way for our providers to access payment services.
EERS offers providers a standardized method of electronic payment and remittance while also expediting the payee enrollment and verification process. Providers can use the Change Healthcare tool to manage ETF and ERA enrollments with multiple payers on a single platform.
How does it work?
EERS gives 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. Registration can also be completed using a national provider identifier (NPI) for payment across multiple accounts.
Providers who currently use Change Healthcare as a clearinghouse will still need to complete EERS enrollment, but providers who currently have an application pending with Change Healthcare will not need to resubmit. Once enrolled, payees will have access to the Change Healthcare user guide to aid in navigation of the new system.
How and when do I enroll?
All integrated Aetna plans will migrate payee enrollment and verification to EERS. To enroll in EERS, please visit https://payerenrollservices.com/.
How can I resubmit a claim?
Claim resubmissions (corrected claims)
With a claim resubmission, you’ve corrected the claim itself and chosen “Corrected” as the Bill Type code. You will resubmit the claim by mail:
Write “RESUBMISSION” across the top of your paper claim resubmission.
Then, mail it to:
Aetna Assure Premier Plus (HMO-DSNP)
Claims and Resubmissions
PO Box 982967
El Paso, TX 79998-2967
Claim reconsiderations
With a claim reconsideration, you’re not correcting the claim in any way. But you disagree with the original claim outcome and want to challenge the payment or denial of a claim.
- Claim Reconsiderations for (PAR) providers (Dispute) – a claim for a PAR provider in which the provider is not correcting the claim in anyway, but disagrees with the original claim outcome and wishes to challenge the payment or denial of a claim. This requires the provider to fill out the PAR Provider Dispute Form (PDF)
- Alternatively, a PAR provider can also submit a Reconsideration via the Provider Portal for better convenience. Once the provider has access, instructions for reconsideration submission through the portal can be found here (PDF).
- Claim Reconsiderations for non-PAR providers (Appeal) - a claim for a non-contracted provider in which the provider is not correcting the claim in anyway, but disagrees with the original claim outcome and wishes to challenge the payment or denial of a claim. This requires the provider to fill out the non-PAR Provider Appeal Form (PDF).
Questions about claims or electronic billing?
You can call Provider Services at
1-844-362-0934 (TTY: 711).