![]() ![]() If a provider’s tax identification number (TIN) is active in multiple states, a single registration will auto-enroll the payee for multiple payers. Providers can use the Change Healthcare tool to manage ETF and ERA enrollments with multiple payers on a single platform.ĮERS gives payees multiple ways to set up EFT and ERA in order to receive transactions from multiple payers. Please note, these are mailed to the New Albany, Ohio address listed at the top of the form.Īetna Better Health of Ohio 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.ĮERS offers providers a standardized method of electronic payment and remittance while also expediting the payee enrollment and verification process. ![]() Federal regulations 42 CFR 42 § 422.504(g) requires us to protect Aetna Better Health members from financial liability, therefore, appeals must include a signed Waiver of Liability (WOL) form. You may submit an appeal for a claim denied based on error or absence of fact, except for timely filing. This requires the provider to fill out the non-PAR Provider Appeal Form: Once the provider has access, instructions for reconsideration thru the portal can be found here.Ĭlaim 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 request access to the portal. This requires the provider to fill out the PAR Provider Dispute Form:Īlternatively, a PAR provider can also submit a Reconsideration via the secure web portal for better convenience. Please note, claim resubmissions are mailed to the following address:Ĭlaim 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. Paper claims should also have the word ‘RESUBMISSION’ written across the top of the claim. ![]() Resubmitted claims should be clearly marked “Resubmission” on the envelope.įor out-of-network providers seeking payment of claims for emergency, post-stabilization and other services authorized by us, please refer to the policies and procedures in the provider manual.Ĭlaim Resubmission (Corrected Claim) – a claim that is resubmitted to ABHO via the same process of a new day claim (via provider’s claims tool, Aetna’s claims portal, or mailed) but the claim itself has been corrected in some way and the claim is designated as ‘Corrected’ via Bill Type code. Or you can mail hard copy claims or resubmissions to:Īetna Better Health of Ohio (M圜are Ohio Program) Obtaining a Claim status in ConnectCenterĬontact your Provider Services representative for more information on electronic billing.Keying Institutional Claims in ConnectCenter.Keying Professional Claims in ConnectCenter.Getting Started with Claims in ConnectCenter.Getting Started with Provider Management in ConnectCenter.Getting Started with Eligibility in ConnectCenter.Please review the guides below for verifying member eligibility and claim submissions. Change Healthcare has produced and made available the Getting Started with the Sign-Up process guide (PDF) to assist in general navigation and registration with ConnectCenter powered by Change Healthcare office. In order to ensure that you have as much time as possible to transition to ConnectCenter, we highly recommend that you start using it immediately. To read the WebConnect manual click here. WebConnect is our free provider claims submission portal and has replaced Emdeon Office as of April 2021. (Federally Qualified Health Centers and Rural Health Clinics must use the Provider ID # when billing Ohio Department of Medicaid.) Please use the following Submitter ID and Provider ID numbers when submitting claims to the health plan: Submitter ID# 50023 and Provider ID# 0082400 for both CMS 1500 and UB 04 forms. Aetna Better Health of Ohio encourages providers to electronically submit claims, through WebConnect. ![]()
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