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Claims
Providers can file claims with Aetna Better Health® of California online or through the mail. Aetna Better Health of California works to streamline processing. And improve payment turnaround time, so you can save time and effort.
You can submit a claim:
Online
Online
You can submit claims online or resubmissions through ConnectCenter. This is our free provider claims submission portal via Change Healthcare (formerly known as Emdeon or WebConnect). To register or log in, please click the link below and follow the prompts.
By mail
By mail
You can also mail hard copy claims or resubmissions to:
Aetna Better Health of California
Claims and Resubmissions
PO Box 982971
El Paso, TX 79998-2971
Resubmitted claims should have “resubmission” marked clearly on the claim form to avoid being denied as a duplicate.
How do I file a claim?
How do I file a claim?
First, you need to fill out a claim form. If you are resubmitting a claim, you need to write “resubmission” on the paper claim form. You must file claims within 180 days from the date services were performed, unless there’s a contractual exception. For inpatient claims, the date of service refers to the member’s discharge date. You have 90 days from the paid date to resubmit a revised version of a processed claim.
Electronic funds transfer (EFT) and electronic remittance advice (ERA)
EFT makes it possible for us to deposit electronic payments directly into your bank account. You can get an EFT form here or on our Provider Portal. Some of the benefits of setting up an EFT include:
- Improved payment consistency
- Fast, accurate and secure transactions
- Payments sent directly into your bank account
- Reduced manual posting of claim payment information, which saves you time and money, allowing you to more efficiently manage your resources
- Elimination of the need for paper Explanation of Benefits (EOB) statements
Aetna Better Health is partnering with Change Healthcare to introduce the new EFT/ERA Registration Services (EERS), a better and more streamlined way for our providers to access payment services. EERS will give payees multiple ways to set up EFT and ERA in order to receive transactions from multiple payers. If a provider’s tax identification number (TIN) is active in multiple states, a single registration will auto-enroll the payee for multiple payers. Registration can also be completed using a national provider identifier (NPI) for payment across multiple accounts.
All Aetna Better Health plans will migrate payee enrollment and verification to EERS. To enroll in EERS, please visit https://payerenrollservices.com/.
How can I resubmit a claim?
A claim may be resubmitted if it was denied or incorrectly paid due to missing documentation or another processing error. You must clearly write “resubmission” and mail it with the following:
- An updated copy of the claim — all lines must be rebilled
- A copy of the original claim (reprint or copy is acceptable)
- A copy of the remittance advice on which the claim was denied or incorrectly paid
- A brief note describing the requested correction
- Any additional required documentation
If you are resubmitting through the WebConnect portal, you will need to identify your resubmission with a “7” in the indicator field. When submitting claims to our plan, use the provider ID number "128CA" for both CMS-1500 and UB-04 forms. You can easily request to have a dispute resolved. You just have to follow the instructions on our dispute resolution form and mail it to us. You can learn more about this process on our “Provider grievances and appeals” page.