Aetna's logo

Aetna.com. Aetna Dental Home.Aetna Dental FAQs. Email Us

.

.Members and Consumers.|.Employers.|.Producers

.
.
.
.
Aetna Dental Networks
Small BoxInformation About Aetna Dental Networks
Small BoxRequest an Application To Join
Claim Resources
Small BoxDownload Claim Form
Small BoxClaim Documentation Guidelines
Small BoxTips for Submitting Claims and Encounters to Aetna
Small BoxOrthodontic Claim Tips
Small BoxUnderstanding Aetna Oral Surgery Benefits
Small BoxUnderstanding Explanation of Benefits (EOB)
Small BoxPaper Claim Tips
Small BoxGet Paid Directly with AutoDebit
Small BoxSalzmann Evaluation Form
Electronic Services banner
Small BoxAetna Payer IDs
Small BoxInformation About Electronic Services
Small BoxNational Provider Identifier (NPI)
Small BoxElectronic Attachments
Small BoxHelp With Electronic Transactions
Small BoxElectronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT)
Small BoxAetna Voice Advantage (SM)
Educational Resources
Small BoxReminder: Annual Required Medicare Training
Small BoxPractice-Management Coach
Small BoxLinking Dental Care to Overall Health
Small BoxEducational Site for Your Patients
Small BoxPlan for Your Health
(A Site for Your Patients)
Agreement With Dentists
Small BoxOur Commitment to the Dental Community
Other Helpful Tools
Small BoxDocFindŽ Provider Directory
Small BoxTelephone Numbers and Addresses
Small BoxSpanish for the Dental Office
Aetna Polices yellow bar
Small BoxAppeals Policy
Small BoxDental Clinical Policy Bulletins
Small BoxPreparing for Possible Pandemic
.
.
.
Claim Status Inquiry
Overview

.
.Overview.
.Claim Status Inquiry Transaction Request.
.Claim Status Inquiry Transaction Response.
.

Overview
Highlights of the electronic Claim Status Inquiry transaction are:

  • Claims processing information is currently available for Aetna Dental products. Those products include: Indemnity, PPO, DMO, Aetna Advantage Plus, Aetna Advantage Dental, Basic Dental, Family Preventive, Discount Dental and Pediatric Direct Access.
  • Available for both paper and electronic claim submissions
  • Transaction is available Monday through Saturday 24 hours per day and on Sundays from noon until 4 a.m.
  • Minimal wait time
  • Decreased manual processes, such as telephone calls
  • Initial receipt or rejection of claims (i.e., a claims acceptance or rejection after Aetna’s initial validation of the information found on the claim)

Back To Top

Claim Status Inquiry Transaction Request
The following elements capture all the information needed to find claims in Aetna’s files:

  • Member ID or Social Security number
  • Subscriber’s last name
  • Patient relationship to the employee
  • Patient first and last name
  • Patient date of birth
  • Patient gender
  • Provider billing tax identification number and/or provider PIN
  • Date of service range

Back To Top

Claim Status Inquiry Transaction Response
A prompt electronic response will be returned with the following elements:

Claim level:

  • Claim number
  • Total charged amount
  • Statement from and through date
  • Status message
  • Amount paid to the provider
  • Claim adjudication date
  • Check number/EFT trace number

Line level:

  • Procedure code
  • Procedure code modifier
  • Units of service
  • Charged amount
  • Amount paid to the provider at the line level
  • Status codes at the line level
  • Line date(s) of service
  • Institutional revenue code

Back To Top


Copyright 2001-2014 Aetna Inc. .

Web Privacy Statement.Legal Statement.Privacy Notices.Member Disclosure