Forms

ERA and EFT enrollment forms have changed. Enroll by downloading the paper forms or enroll electronically by visiting the our Secure Web Portal.

Make sure your contact information is current with us. All you have to do is fill out the practitioner information change form and fax it to 1-860-754-5435. Or, email it to ABHProviderRelationsMailbox@AETNA.com.

If you have to make changes to 10+ providers, use our provider roster worksheet. Remember to fill out the entire worksheet. This will allow us to update your provider records timely and meet state and NCQA requirements. Once you've updated the spreadsheet, email it to ABHProviderRelationsMailbox@AETNA.com.

Electronic remittance advice is an electronic file that contains claim payment and remittance information sent to your office. This is sometimes referred to by its HIPAA transaction number, 835.

The benefits of an ERA

  • Reduces manual posting of claims payment information, which saves you time and money, allowing you to more efficiently manage your resources
  • Eliminates the need for paper explanation of benefits (EOBs)

Fill out the ERA/EFT enrollment forms and submit them via our secure fax at 860-262-7836 or via email to Medicaidfinance-PA@aetna.com. Allow 10-15 business days for processing once enrollment form is received. We'll send a confirmation letter to your office indicating the process has been completed.

Need help?
Please contact Provider Relations at 1-866-638-1232 or email ABHProviderRelationsMailbox@AETNA.com with any questions or to check enrollment status. You can also send us a message via our website using the contact us form.

Electronic fund transfer offers electronic payments deposited directly into providers’ bank accounts.

The benefits of an EFT

An EFT can improve the consistency of your payments and provide fast, accurate and secure payments directly into your bank account.

Please allow 10-15 business days for processing once enrollment form is received. We'll send a confirmation letter to your office indicating the process has been completed.

Need help?
Please contact Finance at 1-866-638-1232 or e-mail Medicaidfinance-PA@aetna.com with any questions or to check enrollment status. You can also send us a message via our website using the contact us form.