Improving our customer service to you
We improved our customer service model to give you better service. When you need
to reach us, just use the options below instead of calling your local network contact.
These options are easy to use and will save you time.
First, visit the Electronic Transaction Tools page on our website
• These tools will help you with administrative tasks, like electronic patient referrals
• Email us via the “contact” link on the site, if you can’t find what you need and want
to reach us.
Or, log into our secure provider website on NaviNet®
Here you can:
• Get information on benefits, referrals and claims
• Use our provider payment estimator and submit professional claims
• Update your registration, billing and user profile information easily
• See your patients’ personal health records to help you better coordinate their care
Our automated phone system is always available
With our automated system, you can find out if a procedure needs precertification,
get a patient’s copay or claims status. Call us at:
• 1-800-624-0756 for HMO-based and Medicare Advantage plans.
• 1-888-MDAetna (1-888-632-3862) for all other plans.
If you can’t resolve your issue through the automated system, our provider service
center staff can help.
48.22.800.1 K (3/16)
Spring 2016 • Volume 11, Issue 1
Behavioral Health newsletter
Quality health plans & benefits
Inside this issue
customer service 1
Reader survey 2
Update your office’s
data online 2
New behavioral health
CE programs 3
2016 Medicare compliance 3
OfficeLink newsletter 3
presenters wanted 4
Electronic claims submission 5
Digital member ID cards 5
PROVIDER QUALITY COUNTS
HEDIS® highlight 6
New opioid risk
screening program 7
Clinical practice guidelines 7
and Responsibilities 8
and patient rights 8
AZ – Aetna LeapSM
plans update 9
Carolinas – Aetna LeapSM
plans update 10
Southeastern PA – Aetna
LeapSM plans update 11
Northern VA – Aetna LeapSM
plans update 12
CONTACT US Cont. on page 2
2 Aetna Behavioral Health Insights
Improving our customer service to you (continued)
Our education site at www.AetnaEducation.com is also a great resource
This site offers:
• User-friendly navigation and search
• Free continuing medical education/continuing education courses (CME/CE)
• A variety of office staff courses to help ease administration
• “Share with a colleague” functionality
• Online, live webinars and recorded events
• Valuable reference tools to make your job easier, and much more
Thanks for responding to our reader survey!
We want to make the Aetna Behavioral Health Insights newsletter the best it can be. Thanks for sharing your experiences
as a reader through our survey. Your feedback will help us feature more of the kinds of articles you’d like to see in the future.
The good news is:
• 91.3 percent of readers say our articles are just the right length
• 95.6 percent believe the newsletter is easy to read
Look for articles about your requested topics in upcoming issues of Insights.
Update your office’s demographic data online
If you need to change or update your office’s demographic
information — new email addresses, or a new mailing
address, phone or fax numbers — you can do so through our
secure provider website.*
Our secure site lets you validate the information you submit.
It also ensures that unauthorized individuals aren’t
submitting incorrect information about your office or facility.
You’ll need to register for our secure website
To use the secure website you must first register.
Registration is easy. Once registered, you’ll also be able to
submit claims transactions, check member eligibility and
benefits and even verify referrals.
You may see a letter from us about your data
We may send you a letter asking you to validate
your demographic information. The letter will
show the current information we have on file
for you. We ask that you respond to the letter
with any updates as soon as you can.
*You’ll need to call our Provider Service Center at 1-888-632-3862 for TIN changes/updates.
3 SPRING 2016
Check out new behavioral health CEs on our education site
Our education site for health care professionals is the no-cost single source of learning opportunities for providers like you.
Check out these new behavioral health continuing education (CE) programs at www.AetnaEducation.com:
• Adherence to Prescription Medication
• Eating Disorders and Treatment Updates
• Federal Mental Health Parity & Addiction Equity Act - A Compliance Overview for Clinicians
• Technologies for post-traumatic stress problems: Assisting veterans and others with PTSD
• Understanding Mental Illness: What Individuals and Families Living with the Illnesses Want Professionals to Know
Medicare compliance news for providers – action required
If you’re contracted with us to provide health care services
for our Medicare Advantage plans, you’re considered a “First
Tier Entity.” The Center for Medicare & Medicaid Services
(CMS) requires that you fulfill specific Medicare compliance
program requirements. We describe those requirements in
our First Tier, Downstream, and Related Entities (“FDR”) Medicare
Compliance Program Guide (FDR Guide).
You should review our FDR Guide and make sure you have
processes in place to comply with all the requirements. You
can find the FDR Guide on www.AetnaEducation.com.
Complete your attestation now and avoid changes in
Each year you must confirm you’ve met the Medicare
compliance program requirements by completing an
attestation. One attestation meets both Aetna and Coventry
compliance obligations. Not complying could impact your
The attestation is available on NaviNet. If you’ve never used
NaviNet, log in or register today:
• New users: Register for NaviNet
• Existing users: Log in to NaviNet
Once you log in, visit the Aetna Plan Central. Hover over
“Compliance Reporting” (on the left) and then click “Medicare
We’re here to help
If you need more information, you can find educational
content on www.AetnaEducation.com by typing “FDR” in
the search box. Or, you can call 1-800-624-0756.
You can disregard this notice if you’ve completed your 2016
Don’t forget to read OfficeLink
Aetna OfficeLink Updates™ — our quarterly newsletter for medical providers and other health care professionals — may also offer
articles useful to behavioral health practitioners. Get this publication on our website.
Consider becoming an Aetna Resources for Living seminar presenter
Aetna Resources For Living, our EAP, offers a broad range of
seminars to our customers. Categories include EAP service
orientation, daily living, health and well-being and
These seminars are delivered both face to face and virtually at
our customers’ locations nationwide. Our training network
includes behavioral health and training professionals with
varied expertise and backgrounds.
We invite qualified professionals to join our educator
We’re looking to expand our educator network. Qualifications
for trainers include:
• A minimum of two years of training experience
• Ability to adapt to a wide range of demographics
• A minimum of two years working with an EAP
If you’re interested in becoming a part of this educator
network email us at [email protected] One of
our staff members will reach out to set up an interview.
Aetna Behavioral Health Insights4
5 SPRING 2016
Get paid faster by submitting all of your claims electronically
Submitting all of your Aetna claims electronically means you’ll receive faster payments. Don’t have billing software?
Register for our free secure provider website on NaviNet and start submitting your professional claims for free!
See how much you can save by doing all business with us electronically
Doing business with us electronically means more than just sending us your claims electronically. You can also check your patients’
eligibility and request precertification online. When you send us electroni