Coverage profile
Work Aetna across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Aetna.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Aetna.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Aetna.
Appeals agent
AI appeals workflowThe Substrate Appeals Agent can submit appeals for RFIs, medical record requests, downcoding reconsiderations, and more via the payer portal for Aetna.
Other aliases
Also known as
- 10004
- 10397
- 4500
- 60054
- 60054MA
- 60055
- 6400
- 953402799
- Z95668
- Aetna Affordable Health Choices (SM) SRC
- Aetna Insurance Company
- Aetna Medicare Advantage
- Aetna Medicare Replacement
- Bell Atlantic
- Choice Plus (TRW)
- CustomCare (Prudential)
- EmoryCare (Prudential)
- FlexCare
- Florida Power and Light (Prudential)
- Foreign Service Benefit Plan
- Healthcare Alliance (Sears)
- IBM Medical Plans
- Innovation Aetna
- Los Alamos Total Care (Prudential)
- Mail Handlers Benefit Plan - MHBP
- Marriott
- MedConnection (Marriott)
- Minneapolis Prudential
- NEA Group Insurance (Prudential)
- Pacific Gas and Electric (PG&E)
2027 maternity billing research
When does Aetna change OB/GYN billing?
For Aetna commercial and Medicare members, the announced CPT framework replaces global maternity codes with service-level coding across antepartum, labor management, delivery and postpartum care beginning 2027-01-01; operational and claims-processing details remain forthcoming. For qualifying patients expected to deliver in 2027, bill preventive prenatal visits on or after 2026-09-01 with the applicable E/M code, modifier TH and pregnancy diagnosis code(s), subject to the stated visit-count rule.
- Transition start
- 2026-09-01
- Billing start
- 2027-01-01 — CPT framework; implementation details forthcoming
- Published
- 2026-09
- Current As Of
- August 2026
Scope: Aetna commercial and Medicare medical maternity services. This article does not establish applicability to Medicaid, dental, vision or separately identified affiliates and products.
OfficeLink Updates — September 2026: Maternity care services coding changes. Verify the payer source before claim submission.
Frequently asked questions
Aetna payer FAQs
How do I check claim status with Aetna?
Providers check Aetna via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Aetna portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Aetna?
The primary payer ID for Aetna is 60054. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Aetna?
The provider portal for Aetna is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Aetna?
The 837P and 837I payer ID for Aetna is 60054 via Stedi.
What is the 835 payer ID for Aetna?
The 835 payer ID for Aetna is 60054 via Stedi.
What is the 270 payer ID for Aetna?
The 270 payer IDs for Aetna are 60054 via Stedi and 60054 via Availity.
What is the 276 payer ID for Aetna?
The 276 payer IDs for Aetna are 60054 via Stedi and 60054 via Availity.
Routing reference
Aetna payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | AetnaSource: Substrate payer directory · last refreshed |
|---|---|
| 837P professional claims payer IDStedi | 60054Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 60054Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 60054Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 60054Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 60054Source: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 60054Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 60054Source: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Aetna. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: AETNA INSURANCE COMPANY. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Aetna. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
Aetna phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Other stated context phone
- (800) 279-1878Aetna Better Health of Virginia
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(203) 399-5130 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(214) 276-6376 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(305) 760-8739 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(646) 473-7160 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(786) 618-1080 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(800) 225-7620 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(800) 374-1835 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(800) 414-0596 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(800) 521-3605 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(800) 735-7053 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(833) 577-2586 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(866) 238-1399 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(866) 553-8206 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| |
| phone(800) 279-1878 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(800) 441-5501 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(800) 624-3879 | Other stated contextBenefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(844) 362-0934 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(844) 365-4385 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(844) 528-5815 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 221-5656 | Other stated contextBenefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(855) 232-3596 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 242-0802 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 300-5528 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 364-0974 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(855) 463-0933 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(855) 676-5772 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(866) 316-3784 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(866) 329-4701 | Other stated contextBenefit context: Active Coverage; Benefit context: Inactive |
| Health Benefit Plan Coverage |
| phone(866) 600-2139 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(866) 638-1232 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(866) 827-2710 | Other stated contextBenefit context: Active Coverage |
| Health Benefit Plan Coverage |
| phone(888) 348-2922 | Other stated contextBenefit context: Inactive |
| Health Benefit Plan Coverage |
Phone and fax numbers sourced directly from the payer response