Aetna Digital Claims Submission is Now Available!

As of May 12, Aetna Medicare members can now submit claims digitally through the member website. The digital claims submission feature can be used for medical, dental, vision, hearing, and any other service, except pharmacy.  Digital claims submission is available to members with a Medicare Advantage Plans (MA), Medicare Advantage Prescription Drug Plans (MAPD) and Dual Eligible Special Needs Plan(D-SNP).

‍

How to submit claims electronically

• Members will need to be registered with a username and password.
• When they access the feature, they'll need to complete the digital form and upload the original itemized receipts/bills with proof of payment on the secure AetnaMedicare.com member website. 
• The form/claim must be submitted within 365 days from the date of service to be eligible for reimbursement. If approved, it can take up to 45 days for members to receive payment.

Members should not complete the claim form located in the Forms library on the website when they’re digitally submitting a claim via the new claim submission feature on Aetna Medicare. The Digital Claim Submission feature eliminates the need for this step. The feature itself, along with the itemized bill, captures all of the necessary information.

‍

A couple factors to keep in mind when using digital form submissions

• Members cannot submit pharmacy claims electronically.
• Claims are viewable in the digital claims submission database (ECHS) within 36 business hours.
• Limitations - Members can upload up to 5 attachments, but the combined size cannot exceed 5 MB.
• The 45 days claim processing timeframe does not change for electronic submission for member reimbursement.