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Claims
Providers can file claims with Aetna Better Health® of Maryland electronically or through the mail. Aetna Better Health of Maryland works to streamline processing. And improve payment turnaround time, so you can save time and effort.
First, you need to fill out a 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 60 days from the paid date to resubmit a revised version of a processed claim.
Online
Availity is our provider portal, which provides functionality for the management of patients, claims, authorizations and referrals. To submit claims online via Availity, choose the button labeled “Medicaid Claim Submission – Office Ally.” This link will take you directly to the Office Ally website where you can submit claims using their online claim entry feature or by uploading a claim file.
Providers must have an Office Ally account to submit claims online. Submission of your Aetna Better Health of Maryland claims using Office Ally is free of charge. The status of claims submitted online should be managed through your Office Ally Account.
By mail
You can also mail hard copy claims or resubmissions to:
Aetna Better Health of Maryland
Claims and Resubmissions
PO Box 982968
El Paso, TX 79998-2968
Use 128MD for your payer ID. Resubmitted claims should have “resubmission” marked clearly on the claim form to avoid being denied as a duplicate.
You can resubmit a claim through Availity or by mail. If you resubmit by mail, you’ll need to include these documents:
- 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
You may file a payment dispute verbally or in writing. We can help resolve billing, payment and other administrative disputes for any reason, including, but not limited to:
- Lost or incomplete claim forms or electronic submissions
- Requests for more info about services or treatment by a health care provider
- Inappropriate or unapproved referrals by the provider
Provider payment disputes don’t include disputes related to medical necessity.
Just call 1-866-827-2710 (TTY: 711) to file a verbal dispute.
To file a written dispute, submit a a Provider Resubmissions and Dispute Form (PDF) with any supporting documentation to:
Aetna Better Health of Maryland
Claims and Resubmissions
PO Box 982968
El Paso, TX 79998-2968
If the dispute is about claim resubmission or reconsideration, we may refer it to the Claims Inquiry Claims Research department. Then, we’ll notify you about the dispute resolution by phone, email, fax or mail.
If you’re not satisfied with the outcome of your dispute you can learn more about filing grievances and appeals.
EFT/ERA Registration Services (EERS)
EERS offers our providers a more streamlined way to access payment services. It gives you a standardized method of electronic payment and remittance while also expediting the payee enrollment and verification process.
EFT makes it possible for us to deposit electronic payments directly into your bank account. Some benefits of setting up an EFT include:
- Improved payment consistency
- Fast, accurate and secure transactions
ERA is an electronic file that contains claim payment and remittance info sent to your office. The benefits of an ERA include:
- Reduced manual posting of claim payment info, which saves you time and money, while improving efficiency
- No need for paper Explanation of Benefits (EOB) statements
EERS offers 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. You can also complete registration using a national provider identifier (NPI) for payment across multiple accounts.
ECHO Health processes and distributes claims payments to providers. To enroll in EERS, visit the Aetna Better Health ECHO portal. You can manage electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollments with multiple payers on a single platform.
Sign up for EFT
To sign up for EFT, you’ll need to provide an ECHO payment draft number and payment amount for security reasons as part of the enrollment authentication. Find the ECHO draft number on all provider Explanation of Provider Payments (EPP), typically above your first claim on the EPP. Haven’t received a payment from ECHO before? You’ll receive a paper check with a draft number you can use to register after receiving your first payment.
Update your payment or ERA distribution preferences
You can update your preferences on the dedicated Aetna Better Health ECHO portal.
Use our portal to avoid fees
Fees apply when you choose to enroll in ECHO’s ACH all payer program. Be sure to use the Aetna Better Health ECHO portal for no-fee processing. You can confirm you’re on our portal when you see “Aetna Better Health” at the top left of the page.
Be aware — you may see a 48-hour delay between the time you receive a payment, and an ERA is available.