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News and notices

Stay up to date on the latest provider news, notices and other helpful information.

News

Notices

  • Aetna Better Health® of West Virginia regularly reviews and analyzes claim composition to identify opportunities for improvement. To that end, we are working with Cotiviti Healthcare (Cotiviti) to assist us with provider claim reviews and reimbursement review practices. Cotiviti performs reviews of medical records for services rendered and conducts post payment reviews of medical claims.

     

    As a provider for Aetna Better Health of West Virginia, you may receive communication from Cotiviti requesting additional information or sharing our findings pertaining to those reviews. 

     

    Questions?

     

    Just call Provider Relations at 1-888-348-2922 (TTY: 711). You can call Monday through Friday, 8:30 AM to 5 PM.

     

    Critical care limits (PDF)

  • Documentation must include:

     

    • Amount of code units completed 
    • Amount of code units being requested 
    • Eight current weeks of drug screening test results 
    • Eight current weeks of therapist and physician treatment notes 

  • Aetna and Quest Analytics Partnership (PDF)

     

    Bureau for Medical Services’ (BMS) right to collect from providers (PDF)

Updates and helpful information

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