For Providers

Welcome, providers!

We see you as our ally in providing high-quality health care services to our members in the Aetna Better Health of Ohio, a MyCare Ohio plan. We are a Medicare-Medicaid plan for dual-eligible members. As you strive to deliver the best care possible and to better understand Aetna Better Health, we hope you’ll take advantage of all the resources we have to offer.

We provide our members with access to important health care services and programs. We designed this to be convenient for our members and providers.

Members must live in one of these counties:

Northwest Region Counties (Metro Toledo area): Fulton, Lucas, Ottawa or Wood
Southwest Region Counties (Metro Cincinnati area): Butler, Clermont, Clinton, Hamilton or Warren
Central Region Counties (Metro Columbus area): Delaware, Franklin, Madison, Pickaway or Union

Because Aetna Better Health of Ohio manages both Medicare and Medicaid coverage, our members only have to work with us. We take care of it all, including dental, vision and mental health benefits, and more. It also simplifies your office processes.

Plus, we work to make it easy for you to care for our members and guide them down the path to better health.

 

ATTENTION ALL PROVIDERS:

Remittance Advices (RA) are located on Aetna Better Health's secure web portal. It is the provider's responsibility to download and save or print and save these payment registers for payment reconciliation and required documentation retention. We will no longer reprint RAs for providers or vendors contracted with providers. Providers must log in to the secured portal and obtain the RA when one is posted, and they must make arrangements to supply these documents, or give access to these documents, to any contractor/vendors working on their behalf.

Financial Liability for Payment of Services

Balance billing enrollees is prohibited under the MyCare Ohio plan. In no event should a provider bill an enrollee (or a person acting on behalf of an enrollee) for payment of fees that are the legal obligation of Aetna Better Health of Ohio. This includes any coinsurance, deductibles, financial penalties, or any other amount in full or in part.

Providers must make certain that they are agreeing not to bill an enrollee for medically necessary services covered under the plan and to always notify enrollees prior to rendering services. Providers must also make certain that they are agreeing to clearly advise an enrollee, prior to furnishing a non-covered service, of the enrollee's responsibility to pay the full cost of the services.

Aetna Better Health of Ohio Behavioral Health Redesign Overview Video