Please review the updated attachments sent via fax blast or USPS mail to all providers.
- Provider Letter: Edifecs Smart Trading platform - effective 1.20.2025
- Enhancing claims EDI intake editing
- Provider EDI claim submission processes will NOT be affected by this change
- Provider Letter: Lab Code changes – effective 1.1.2025
- CPT codes: 81513 & 81514- These two codes will no longer be managed through the prior authorization process. Claims will be reviewed and approved based on appropriate diagnosis.
- Provider Letter: ABH Medicaid New Policies implemented – effective 2.1.2025
- OB Ultrasound Studies: CPT codes: 76856 & 76857- deny based on diagnosis codes submitted listed in the letter
- Behavioral Health Per Diem: Deny the list of codes submitted listed in the letter when quantity exceeds 1 unit per day by any provider
- Provider Letter: Provider Registry Taxonomy Rejection Notification – 10.2.2024
- Notice of New Aetna Better Health of Michigan (ABH) Medicaid Claims and Encounters Front End Edits
- Provider Letter: Provider Transition of Care – effective 10.1.2024
- RFP Region 7 (Clinton, Eaton, and Ingham counties) – Medicaid beneficiaries will be assigned to a new health plan effective 10.1.2024. ABH expects to have a large volume of Medicaid beneficiaries in Region 7.
- New Policy Updates: Clinical Payment, Coding and Policy Changes – effective 12.1.2024
- New Policy Updates: Clinical Payment, Coding and Policy Changes – effective 10.1.2024
- Medicare Compliance FDR newsletter – Q3, 2024
The information above is found on line on our website at: https://www.aetnabetterhealth.com/michigan/index.html
- Provide Site
- Notices and newsletters
- Provider newsletters
- Provider letters
- State bulletins
- First Tier, Downstream and Related Entities (FDR) newsletters (Medicare-Medicaid plan)
Attachments