Aetna Medicare Advantage
Also covers / subsidiaries: Aetna, Aetna Medicare, Aetna MA, CVS Health
Core Payer & Clearinghouse Profile
Electronic Payer ID
10004
60054 is Aetna's primary/universal claims payer ID. Confirm with your clearinghouse and the member's MA plan.
Timely Filing Limit (TFL)
Per provider contract; commonly up to 365 days from DOS. Verify against your contract
Appeal Window
Medicare Advantage appeals follow CMS Part C rules (commonly 60 days from the denial/organization determination)
Clearinghouse Gateway
Availity
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://www.aetna.com/health-care-professionals.html
Aetna (a CVS Health company) is a major Medicare Advantage carrier.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Aetna Medicare Advantage.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Aetna Medicare Advantage.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Aetna | 10004 | Par | None | 837P837I270/271276/277Dental |
| Aetna | 60054 | Par | Required | 837P837I835 ERADental |
| Aetna Dental Plans | 60054 | Par | None | 837P837I835 ERADental |
Resolution Tools for Aetna Medicare Advantage Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
Tired of Chasing Aetna Medicare Advantage Denials & Delayed Payments?
Aethera's billing specialists work Aetna Medicare Advantage every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.