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Aetna Web Service Explains Claim Coding

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NU Online News Service, Sept. 22, 2003, 5:03 p.m. EDT – Aetna Inc., Hartford, has introduced Clear Claim Connection, a Web-based service that will give doctors and hospitals detailed explanations of how Aetna analyzes and pays specific claims.

Providers can use the service to see how Aetna’s claims-processing system will handle standard billing codes, Aetna says. The service also will explain why Aetna translates a billing code, or a bundle of codes, into another code before paying a claim.

Aetna says it added the service to its provider Web site in part to make good on a commitment it made in May to cooperate more with the doctors. Aetna made the commitment in connection with efforts to settle its share of litigation involving several large managed care companies and hundreds of thousands of doctors throughout the United States.