News
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MyDecision Dissemination Packet (PDF)
Time to Register! Aetna Better Health Webinar Understanding the CAHPS (PDF)
Changes to billing for adult dental services (PDF)
Approved negative balance network notice (PDF)
All suppliers provider notice (PDF)
Default pricing for professional claims codes notice (PDF)
Duplicate remittance advices (RA) notice (PDF)
Emergency room (ER) level of care policy update (PDF)
Prior authorization bundles for oncology (PDF)
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Notices
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Aetna Better Health® of West Virginia regularly reviews and analyzes claim composition to identify opportunities for improvement. To that end, we are working with Cotiviti Healthcare (Cotiviti) to assist us with provider claim reviews and reimbursement review practices. Cotiviti performs reviews of medical records for services rendered and conducts post payment reviews of medical claims.
As a provider for Aetna Better Health of West Virginia, you may receive communication from Cotiviti requesting additional information or sharing our findings pertaining to those reviews.
Questions?
Just call Provider Relations at 1-888-348-2922 (TTY: 711). You can call Monday through Friday, 8:30 AM to 5 PM.
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Documentation must include:
- Amount of code units completed
- Amount of code units being requested
- Eight current weeks of drug screening test results
- Eight current weeks of therapist and physician treatment notes
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Updates and helpful information
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PA updates: November 11, 2022 (effective October 15, 2022) (PDF)
PA updates: June 18, 2021 (effective immediately) (PDF)
PA updates: May 4, 2021 (effective July 1, 2021) (PDF)
PA updates: February 5, 2021 (effective April 10, 2021) (PDF)
PA updates: January 21, 2021 (effective March 25, 2021) (PDF)
PA updates: July 1, 2020 (effective August 1, 2020) (PDF)
Eviti Connect go-live date update: July 2, 2020 (effective August 1, 2020) (PDF)
Eviti Connect provider notice: (effective July 1, 2020) (PDF)
Expiration of prior authorization suspension notice: May 27, 2020 (effective June 1, 2020) (PDF)
PA updates: May 15, 2020 (effective August 1, 2020) (PDF)
PA updates: April 1, 2020 (effective immediately through May 31, 2020) (PDF)
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