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Working with Aetna Electronically: Easier for You, More Profitable for Your Business


The following article was written by Aetna as a message to HBMA members. 

We are proud to work with HBMA and, in particular, the Commercial Payor Relations (CPR) Committee. We’ve received many suggestions to make it easier for you and your company to do business with us electronically. Why electronically? Simple – it saves time, and time is money.

Log in, get what you need and log out. There’s no need to call and wait on hold when the information you’re looking for is just a few keystrokes away. And it’s all available on your schedule.

We’re always looking for ways to make doing business with us easier. Read on to see some of the things we’ve been working on – including a few important reminders to help you save time.

  • Change in provider payment policy: We’ve changed our policy on how we’ll pay our providers. Starting this year, we’ll pay providers only by electronic means – that is, either by electronic funds transfer (EFT) or virtual credit card (VCC). What does this mean to your clients? Due to the overwhelming demand, we’re informing our providers in phases. Once your clients receive our letter, they’ll have 90 days to make a choice: either enroll in EFT or choose to process payments by VCC.
    • Your clients can enroll in EFT using the online EFT Enrollment utility from the Council for Affordable Quality Healthcare® (CAQH). Even if your clients use CAQH now for credentialing, separate enrollment for the EFT enrollment utility is required.
    • Clients don’t use CAQH? Print an EFT enrollment form from
    • Providers who don’t enroll in EFT by their stated deadline will be automatically enrolled to receive VCC payments through an arrangement we’ve made with Emdeon.
    • Some important points to keep in mind:
      • Even if your clients haven’t received a letter from us yet, encourage them to make a choice now. For your clients who prefer to accept VCC payments, they can choose one of two vendors:
        • Emdeon: 1-855-723-3475
        • JP Morgan Chase: 1-888-214-3294
      • Medicare and Medicaid require EFT enrollment.
      • HBMA has endorsed our EFT initiative. Jeanne Gilreath, HBMA president, states:

Aetna has been a payor partner with HBMA for several years now, and through regular conversations with representatives from the CPR Committee, the Aetna representatives have come to understand the pain points of our members and their clients.

Significant to the success of the revenue-cycle process is full automation. As one of the nation's leading payors, Aetna is committed to advancing the use of technology to support the reduction of costs, as well as the elimination of paper waste and cumbersome processes that plague our industry. By setting a goal to have 100 percent EFT enrollment by May 1, 2014, Aetna is working diligently to support administrative simplification.  

Billing companies with a focus on efficient processes should be one of the early adopters of the EFT process, so make sure all of your clients are taking advantage of automated processes that will improve the bottom line of your company.

  • Change in print vendor: For your clients who still receive paper explanation of benefits (EOB) statements, we’d like to let you know we’ve changed how we send out our EOBs. We’re working with HealthPayers USA (HPUSA), a service provided by Emdeon, to send our paper EOBs. You’ll start to receive packages from HPUSA that contain our checks and EOBs, though at times you might receive mailings directly from us.
    • Make it simple and go paperless: if your company processes electronic remittance advice (ERA) files for other clients, get an ERA/EFT enrollment form from our website and enroll all of your clients.
    • Don’t process ERA files? You can still go paperless. We’ve included instructions above on how to enroll in EFT. Enroll in Aetna’s secure provider website on NaviNet® as a billing company, and access all of your clients with just one user name!
  • Updated Aetna website: We’ve updated the look of our website. Try it out! Go to You’ll find helpful information and resources within the Healthcare Professionals pages.
  • Updated Aetna Education site: We’ve also updated our educational site at Take a look! No registration is required. You can browse topics of importance to you, find helpful tools in our Reference Tools area, like the new interactive rejected/returned claims resolution tips guide. You can even enroll in free, live educational webinars from the Webinar Calendar link. Can’t find what you’re looking for? Click the “Ask an Expert” link to send us a question.
  • Send all of your clients’ Medicare claims electronically: Did you know we can accept all Medicare claims electronically? Whether you’re sending Part A, B or Supplemental claims, we’d like to remind you to submit all of your clients’ claims electronically.

Want more information about doing business with Aetna? Look for our joint HBMA/Aetna live webinar on July 22 and our participation in the HBMA Multi-Payor Forum.