1. Contract Effective Date
Product
PPO/Non HMO based plans
March 1, 2004
Fee Schedule
Physician listings are available via the internet on the Aetna Physician Website at:
Referral Procedures
Members have open access to specialty providers. To ensure maximum coverage for the member, please refer to other participating providers whenever possible.
Precertification Process
Precertification is required for all elective inpatient admissions and selected outpatient procedures prior to rendering services. Please contact precertification at (toll free).
Emergency admissions require notification within 24 hours. Please contact for precertification at (toll free).
Contract Effective Date
Reimbursement
Network
Medical Management

2. Claims Submission Phone Numbers
All claims should be submitted electronically with payor ID
Claims may be submitted via paper to the following address: PO Box 14079, Lexington, KY
Deductible, coinsurance, copayment information and benefits should be verified by reviewing Member’s ID card
All claims should be submitted within 30 days
All Membership cards must display the Aetna logo.
Aetna
Provider Relations
PPO Member Services
Patient Management
NIA – radiology Precertification (tolll free)
Kids First Pediatric Alliance
Main number
Phone Numbers