Aetna for billing teams
Payer ID, timely filing, appeals and prior authorization for aetna commercial plans, from Aetna's own documents, checked in October 2026.
What you get
- Payer IDs, filing limits and appeal deadlines
- A link to the payer's own document for each one
- An email when a payer changes a rule
Aetna
Aetna commercial plans · checked in October 2026
- Payer ID for claims
- 60054 for claims and encounters.Aetna, Eligibility, benefits and claims information
- Timely filing limit
- Not published nationally. Check your participation agreement.
- Appeal deadline
- Reconsideration within 180 calendar days of the initial claim decision, then an appeal within 60 calendar days of that decision.Aetna, Provider disputes and appeals
- Prior authorization
- By EDI, through Availity, or by phone on the number on the member's ID card. Look up codes with the Precertification Code Search tool.Aetna, Precertification lists
- Pharmacy prior authorization
- Through Availity, with specialty drugs on the Novologix platform.Aetna Provider Manual
- Eligibility checks
- Availity, or 270/271 through your clearinghouse.Aetna, Electronic transaction vendors
- Provider portal
- Availity, Aetna's preferred portal.Aetna Provider Manual
- Provider phone
- 1-888-632-3862. For Medicare Advantage and HMO-based plans, 1-800-624-0756.Aetna Provider Manual