Aetna timely filing limit

Aetna timely filing limit to submit the initial claims is 180 days from the date service rendered, for Aetna reconsideration we have to file within 180 days from the initial claim decision and appealing limit is 60 days from the previous decision.

Aetna Medicare timely filing limit

It is same as Aetna commercial time frame as stated above i.e.

• Initial Claims: 180 days from the date service provided.
• Reconsideration: 180 days (From the initial claim decision) and
• Appealing limit: 60 days (From the previous decision)

Effective May 1 2023, the new filing requirement for Texas is within 95 days from the date of service. All Texas claims must be submitted within 95 days from the date service rendered.

Aetna Better Health Timely Filing Limit:

For Aetna Better Health and Aetna Better Health Kids, we should submit the claims within 180 days from the date service rendered except stated within the provider contract and claim resubmissions should be submitted within 365 days from the date of the EOB or provider remittance advice. Provider should appeal the claim within 60 days from the claim denial date unless otherwise stated within the provider contract. If you have any questions on claims processing of Aetna Better Health claims then please do contact claims inquiry department @ 1-866-638-1232(Option 3).

Aetna timely filing limit 2024 list for initial claim payment dispute:

State	Time	Remarks
Arizona	1 year	Participating Provider and Non-Participating Providers
California-HMO	365 days	Participating Provider and Non-Participating Providers
California-Traditional	180 days	Participating Provider and Non-Participating Providers
Colorado	12 months	Participating Provider and Non-Participating Providers
Florida	12 months	Participating Provider and Non-Participating Providers (Note: Does not apply to facility)
Georgia	2 years	Participating Provider and Non-Participating Providers
Indiana	2 years from claim payment date	Participating Provider and Non-Participating Providers
Kentucky	2 years	Only Participating provider
Maryland	365 days	Participating Provider and Non-Participating Providers
New Jersey	90 days from the notice of the disputed claim determination
New Jersey	18 months from the date the first payment of a claim was made
North Carolina	2 years from the original claim payment	Participating Provider and Non-Participating Providers
Ohio	2 years	Participating Provider and Non-Participating Providers
Oklahoma	2 years	Participating Provider and Non-Participating Providers
Oregon	18 months from the claim denial	Participating Provider and Non-Participating Providers
Rhode Island	18 months	Participating Provider and Non-Participating Providers
Tennessee	18 months	Participating Provider and Non-Participating Providers
Washington	24 months from the denial date or payment date	Participating Provider and Non-Participating Providers

State	Time	Remarks
Arizona	1 year	Participating Provider and Non-Participating Providers
California-HMO	365 days	Participating Provider and Non-Participating Providers
California-Traditional	180 days	Participating Provider and Non-Participating Providers
Colorado	12 months	Participating Provider and Non-Participating Providers
Florida	12 months	Participating Provider and Non-Participating Providers (Note: Does not apply to facility)
Georgia	2 years	Participating Provider and Non-Participating Providers
Indiana	2 years from claim payment date	Participating Provider and Non-Participating Providers
Kentucky	2 years	Only Participating provider
Maryland	365 days	Participating Provider and Non-Participating Providers
New Jersey	90 days from the notice of the disputed claim determination
New Jersey	18 months from the date the first payment of a claim was made
North Carolina	2 years from the original claim payment	Participating Provider and Non-Participating Providers
Ohio	2 years	Participating Provider and Non-Participating Providers
Oklahoma	2 years	Participating Provider and Non-Participating Providers
Oregon	18 months from the claim denial	Participating Provider and Non-Participating Providers
Rhode Island	18 months	Participating Provider and Non-Participating Providers
Tennessee	18 months	Participating Provider and Non-Participating Providers
Washington	24 months from the denial date or payment date	Participating Provider and Non-Participating Providers

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