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  • 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 and e-prescribing.

    • 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

    Aetna Behavioral Health InsightsTM

    Behavioral Health newsletter

    Quality health plans & benefits Healthier living Financial well-being Intelligent solutions

    Inside this issue

    Improving our 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

    EAP CORNER EAP seminar presenters wanted 4

    GET CONNECTED! Electronic claims submission 5

    Digital member ID cards 5


    HEDIS® highlight 6

    New opioid risk screening program 7

    Clinical practice guidelines 7

    Member Rights and Responsibilities 8

    Provider manuals and patient rights 8

    STATE NEWS 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 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

    • Adherence to Prescription Medication

    • Eating Disorders and Treatment Updates

    • Psychopharmacology

    • 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

    Complete your attestation now and avoid changes in participation status 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 participation status.

    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 Attestation.”

    We’re here to help If you need more information, you can find educational content on 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 Attestation.

    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 professional development.

    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 network

    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