Ziziphi iiBillers Medical Medical Need Know About Aetna

Indlela yokuhambisa izimangalo kule Nkxaso-mali

I-Aetna inikeza iinkqubo ezahlukeneyo zeinshorensi zempilo, kubandakanywa nalawo bantu kunye nezicwangciso ezixhaswe ngabasebenzi. Iibhanki zonyango ziyakudinga ulwazi malunga nendlela yokuyihlawula kunye nokuqhuba amabango kulo mkhushurensi. Nayi ulwazi kwiinkqubo zabo.

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Ulwazi oluqhelekileyo kwi-Aetna ngeBill Billers

Iinkcukacha zoNxibelelwano

• IzeMpilo kunye neMpilo yokuziphatha: Kwiiplani ze-HMO kunye ne-Medicare Benevantage, celela 1-800-624-0756. Kuzo zonke izicwangciso, fowuna 1-888-MD-Aetna (1-888-632-3862).
• Ulawulo lwe-Aetna Pharmacy: 1-800-238-6279
• Ababoneleli bamazinyo: 1-800-451-7715
• I-Credentialing okanye i-credential status status: 1-800-353-1232

Ulwazi lweedesi
Aetna Inc.
151 IAvenington Avenue
EHartford, CT 06156

Idilesi yeWebhu
www.aetna.com/healthcare-professionals

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Ulungelelwaniso lwe-Aetna, iiNzuzo kunye neSimo soBango

Ulungelelwaniso lwexesha leNkcukacha ze-Electronic (Time Régibility) (RTE)

• Iifumane iiyure ezingama-24 ngosuku, iintsuku ezi-7 ngeveki
• Itholakale ukuba ithathe inxaxheba kwaye ingabandakanyeli ababoneleli bezempilo
• Ikuvumela ukuba uhambise iimbuyekezo zemibuzo malunga neenyanga ezili-18 ngaphambi komhla okhoyo

Ukufaneleka, iinzuzo kunye nesimo sebango singqiniswa ngeendlela ezimbini:

1. Ngokusebenzisa i-website ye-Aetna ekhuselekile ngewebhusayithi ngeNaviNet®, efumaneka kwi-www.aetna.com/healthcare-professionals
2. Ngomthengisi wekhompyutha / indlu yokucoca

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Indlela Yokuthumela I-Precertification Isicelo se-Aetna

Hambisa izicelo zangaphambili ngaphambi kokuba unike iinkonzo nge-interchange yedatha ye-elektroniki (EDI), nge-www.aetna.com/healthcare-professionals okanye ngefowuni usebenzisa inombolo yocingo kwikhadi lokuchongwa kwamalungu.

Iinkqubo kunye neenkonzo kwizintlu zengqungquthela zingadinga isaziso kunye / okanye isigqibo sokwenza ingxelo.

• Ikhowudi Yokukhangela Ikhowudi yokuQala

1. Faka iikhowudi ze-CPT ukuze ufumane ukuba kufuneka i-precert

• I-Electronic Precertification

1. Ikhona iiyure ezingama-24 ngosuku, ngoMvulo ngoMgqibelo
2. Fumana inombolo ye-ID yesazisi
3. Ukungeniswa kokulahla kunikwa inombolo elandelelanayo yokulandelela

Kaninzi

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Ulwazi lokuhlawula i-Aetna

Kukho iindlela ezintathu ezilula zokungenisa amabango ku-Aetna:

1. Izibhengezo zekhompyutha zingeniswa kwi-website ye-Aetna ekhuselekile ngewebhusayithi ngeNaviNet®, efumaneka kwi-www.aetna.com/healthcare-professionals.
2. Izibhengezo zekhompyutha zingeniswa ngumbhengisi ngekhompyutha / indlu yokucoca.
3. Amaphepha amabango angeniswa kwi-Aetna yeebhanki idilesi yokuposa echazwe kwikhadi le-ID yelungu.

Amabango asekondari:

• Thumela ngekhompyutha
• Faka phakathi ukulungiswa kwemali - kwinqanaba lamabango kunye nenqanaba lomgca wenkonzo (ukuba lukhona)
• Ziquka izizathu zokuhlengahlengiswa - uxanduva lwekhontrakthi, ukuchithwa, uxanduva lwe-coinsurance, njl. Sebenzisa iikhowudi ezinikezelwe ngumvuzo wokuhlawula
• Inani elihlawuliweyo lokuhlawula umvuzo - kwinqanaba lamabango kunye nenqanaba lomgca wenkonzo (ukuba lukhona).

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Izidingo zokuFakela ngexesha

Ngaphandle kokuba umthetho welizwe okanye omnye usebenziso lusebenza:

1. Oogqirha baneentsuku eziyi-90 ukususela ngomhla wokubonelela ukufaka ibango lokuhlawula.
2. Izibhedlele zinomnye umnyaka ukususela kumhla wenkonzo ukuhambisa ibango lokuhlawula.

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Amabango afanelekileyo

Xa wenza utshintsho kumabango ahlawulwe ngaphambili, ngenisa amabango achanekileyo ngekhompyutha. Hlaziya i-Code Frequency Code nge:
7 = Ukutshintshwa kwebango langaphambili
8 = Akukho nto / ikhefu yebango langaphambili

Xa wenza utshintsho kwiimangalo eziphikisiwe ngaphambili, ngenisa amabango achanekileyo kwiphepha:

1. Isitampu "UKUKHALWA KWEENKQUBO" phezulu kwibango
2. Imeyili ku:
   Aetna
   PO Box 14079
   Lexington, KY 40512-4079

Kaninzi

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Imbuyiselo

Hambisa ibango elichanekileyo kwaye i-Aetna iya kubuyiselwa / ibuyisele kwakhona imali eyongezelelweyo eyayiza kuxelwa kwi-ERA ngokuguqulwa kwesigwebo esilunganga, esilandelwa ngumgwebo ochanekileyo webango.

Kaninzi

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I-Aetna yeNkcazo yeSibheno

Ukuqwalaselwa kwakhona

1. Kwiintsuku ezingama-180 zekhalenda yesigqibo sokuqala sebango
2. Kwiintsuku ezingama-3-5 zoshishino zokufumana isicelo. Kwiintsuku ezingama-30 zeentsuku zokufumana isicelo ukuba uhlaziywa yiyunithi ekhethekileyo iyadingeka (umzekelo, ukuhlaziywa kwekhowudi yekliniki
3. Ifowuni ye-1-800-624-0756 yezicwangciso ze-HMO-based based plans kunye ne-WA zokuCwangcisa zePrayimari okanye ufonele u-1-888-632-3862 ukulungiselela izibonelelo kunye neepro
4. Iilesi zokuthumela:
   
   States
   AL, AK, AR, AZ, CA, FL, GA, HI, ID, ID, MS, NC, NM, NV, NOMA, SC, UT, TN, WA
   Idilesi
   I-Aetna PO Box 14079 iLexington, KY 40512-4079
   States
   I-CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, M, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY
   Idilesi
   I-Aetna PO Box 981106 El Paso, TX 79998-1106
5. Thumela kwi-intanethi ngokusebenzisa ithuluzi lokukhangela ibango le-EOB. Ngena kwiwebhusayithi ekhuselekileyo yomboneleli ngeNaviNet® ukufikelela kwesi sixhobo.

Isibheno seNqanaba 1

1. Kwiintsuku ezingama-60 kwikhalenda yesigqibo sokuqwalasela kwakhona
2. Kwiintsuku ezingama-30 zoshishino zokufumana isicelo. Ukuba kukho ulwazi olongezelelweyo olufunekayo, kungakapheli iintsuku ezingama-30 zokufumana ulwazi olongezelelweyo oluceliwe
3. Ifowuni ye-1-800-624-0756 yezicwangciso ze-HMO-based based plans kunye ne-WA zokuCwangcisa zePrayimari okanye ufonele u-1-888-632-3862 ukulungiselela izibonelelo kunye neepro
4. Bhala i-Aetna IsiGqibo seMboneleli we-Aetna PO Box 14020 Lexington, KY 40512

Isibheno seNqanaba lesi-2 (esikhona kuphela kwiingcali)

1. Kwiintsuku ezingama-60 zekhalenda yesigqibo sesibheno seNqanaba 1
2. Kwiintsuku ezingama-30 zoshishino zokufumana isicelo. Ukuba kukho ulwazi olongezelelweyo olufunekayo, kungakapheli iintsuku ezingama-30 zokufumana ulwazi olongezelelweyo oluceliwe
3. Ifowuni ye-1-800-624-0756 yezicwangciso ze-HMO-based based plans kunye ne-WA zokuCwangcisa zePrayimari okanye ufonele u-1-888-632-3862 ukulungiselela izibonelelo kunye neepro
4. Bhala i-Aetna IsiGqibo seMboneleli we-Aetna PO Box 14020 Lexington, KY 40512

Kaninzi