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Aetna recently implemented process improvements that better position them to be the front line of support for provider claim issues.  As a result, providers will now need to use Aetna’s self-serve tools instead of using Midlands Choice as the liaison for Aetna claim issues. 

With this change, the status of claim rework will be available to providers via Aetna’s standard self-serve tools and services (NaviNet and the Provider Service Center) instead of updates sent through Midlands Choice.  Through Aetna’s self-serve functionality, providers will be able to view reports of open or recently closed issues, receive emails with reprocessing status updates, and view reprocessing details for non-project work.  In addition, providers can request a claim project for issues of 10 or more claims for the same provider through the self-serve tools.  

Information regarding the status of a claim, including those submitted via the intake template, can be obtained by calling Aetna’s Provider Service Center by calling:

• 1-888-MD Aetna (1-888-632-3862) for Aetna PPO, Choice POS II, Open Access Aetna Select
• For ASA, the phone number on the back of the member's ID card
• 1-888-772-9682 for Aetna SRC 

Status of claim inquiries can also be viewed by going to Aetna’s secure provider website.  If you are not a registered user of Aetna’s secure provider website, click here and go to the “Sign Up” link under the "Getting Started with NaviNet" section on the left side of the page to register for an account.  

Aetna is offering free webinars on how to use their Claim and Account Management Tools available on their secure provider website, NaviNet.  Click here for more information. 

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