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News
Aetna Out-of-Network Benefit
Recent News
- Aetna Changes Stop Loss Calculations
Published: - Methodist Health System and Jennie Edmundson Hospital
Published: - Floyd Valley Hospital
Published: - City of West Des Moines
Published: - Winneshiek Medical Center
Published: - Spruced-Up Revenue Cycle Precedes Construction Plans
Published: - UNMC Student Plan
Published: - Progressive Swine Technologies
Published: - Christian Brothers Services is New Midlands Choice Payer
Published: - CIGNA Preventive Care Payment Policy Changes
Published: - CIGNA Clinical, Reimbursement and Administrative Policy Updates
Published: - CIGNA Contracts with MedSolutions
Published: - Aetna Electronic Precertification
Published: - Aetna Clinical Payment, Coding and Policy Changes
Published: - New Aetna Precert Requirements Effective July 1
Published: - 5010: Don’t Assume “Someone Else” is Responsible
Published: - New Groups Effective Jan. 1, 2011
Published: - ICD-10 Update
Published: - CIGNA Address Change
Published: - V-Pay Cards
Published: - Include Patient Date of Birth on Claims
Published: - SL Modifiers
Published: - Midlands Choice EDI Contacts
Published: - Aetna Electronic Funds Transfer (EFT)
Published: - Aetna Electronic EOBs
Published: - Aetna Signature Administrators “Cheat Sheet”
Published: - Aetna Alternatives to Paper for When EDI Isn’t Practical
Published: - Aetna Corrected/Voided EDI Claims
Published: - Aetna Clinical Payment, Coding and Policy Changes
Published: - CIGNA Changing Name
Published: - Delegated Payer Claims
Published: - Access to Information During the Credentialing Process
Published: - United Security Life and Health Insurance
Published: - Changing To Online Newsletter
Published: - CIGNA Online Remittance Reports Available in 2011
Published: - Supporting Documentation for CIGNA Electronic Claims
Published: - CIGNA's Use of Modifiers 59 and 25
Published: - CIGNA Code Auditing
Published: - ICD-10 Code Translator
Published: - 5010 Address Requirements
Published: - New Aetna Radiology Preauthorization Requirements
Published: - Great-West Website Has New Look, Upgraded Features
Published: - Aetna Out-of-Network Benefit
Published: - Aetna Offers Multi-Payer Transactions via NaviNet at No Charge
Published: - Changes to 2011 Aetna Precertification List
Published: - Aetna Publishes CT Scan, MRI and Ultrasound Payment Policy
Published: - Mennonite Mutual Aid Announces Name Change
Published: - Paper Claims Must be Typed
Published: - Aetna Review of Hospital Acquired Conditions
Published: - 5010 Preparation Under Way
Published: - News Archives
The out-of-network benefit for many Aetna patients is now based on a percentage of the Medicare fee schedule for the service.
This benefit change took effect for new and renewing plans as of October 1, 2010. Over time, it will become Aetna's standard out-of-network benefit, replacing the "reasonable or prevailing charge" plan language.
As a result of this change, your Aetna patients may see a significant increase in their out-of-pocket costs when care is directed to out-of-network providers. This benefit structure does not apply to emergency services or other benefits considered at the in-network level.
