Dear Behavioral Health Provider,
In an effort to help ensure both of our organizations are prepared for the upcoming Behavioral Health Redesign changes that take effect with the Ohio Department of Medicaid starting on January 1
, 2018, we would like to encourage your organization to participate in a 'claims testing' period. This effort has already begun with our providers. If you are interested in testing with Aetna Better Health
of Ohio, here is what you need to know:
- Aetna Better Health© of Ohio Network Providers should be testing now.
- Behavioral Health providers with no contract can still test with Aetna Better Health© of Ohio after verifying billing information.
- Providers do not have to be fully credentialed to begin testing with Aetna, although providers should work to get providers credentialed prior to the 1/1/18 go-live date.
- Trading partners are not required to have an agreement with Aetna in order to test as long as the Aetna MyCare plan has accurate billing information from the provider.
You can submit claims one of 2 ways
- Submit your 837 Test files through your clearing house to our free Claims Submission portal by marking the file with 'TEST' at the header level. Please work with your vendor to coordinate that with the Gateway. Please send a notification email to OH_BH_Redesign@aetna.com so we may notify our team that a test file is about to be submitted.
Members on Test Claims
While we prefer real member numbers on the test claims, we can also accept fabricated member numbers instead if they are not available. Please use unique fabricated member names for each scenario for testing in order to avoid duplicate editing.
Providers on Test Claims
We do want actual rendering providers on the test claims (active NPI number) so that we can
map the claim correctly to the specialty and test that functionality.
Dates of Service
Test Claims should use 1/1/17 or after for DOS. We cannot accept claims with future dates, as our system will reject these as invalid.
Type of Claims
Please supply multiple claims. Ideally, we would like to see claims that represent the type of services you will be billing for under the BH Redesign program. Please include as much variety of codes, modifier combinations, rendering NPIs and Place of Service (POS) as possible.
If you have any additional questions, please direct them to
. We review this mailbox and respond daily.
Need more help? Just ask in your email to
and we can schedule a time that works for you to have a Provider Relations Liaison meet with you in person to work through your questions and help you navigate the testing process.