Aetna provider portal, phone and payer ID quick facts
| Provider portal | https://www.aetna.com/health-care-professionals.html |
|---|---|
| Provider phone | 1-888-632-3862 |
| Claims payer ID | 60054 |
| Eligibility payer ID | 60054 |
| ERA payer ID | 60054 |
| Timely filing | Plan and state specific; New York reference: 120 days |
| Prior auth route | X12 278 plus provider portal |
| Last reviewed | 2026-04-23 |
- This registry has not established one national timely-filing limit for Aetna. Verify the controlling plan document, provider agreement, denial notice, or jurisdictional rule.
Aetna at a glance
| Legal name | Aetna Life Insurance Company |
|---|---|
| Also known as | Aetna Inc., Aetna Health |
| Category | Commercial |
| Parent organization | CVS Health |
| Claims payer ID | 60054 |
| Eligibility (270/271) payer ID | 60054 |
| ERA (835) payer ID | 60054 |
| NAIC company code | Not established in this registry |
| States covered | Nationwide (50 states) |
| Members covered | ~27 million members |
| Provider portal | https://www.aetna.com/health-care-professionals.html |
| Provider phone | 1-888-632-3862 |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Aetna
Aetna's New York state supplement describes 120 days after service for initial claims, unless a more favorable agreement or a different legal requirement applies. This is not a national participating-provider deadline. Confirm the member's product, state and provider agreement before calculating the filing date.
| Submission type | Window |
|---|---|
| Initial claim reference | Plan and state specific; New York reference: 120 days |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
Reconsideration and appeal routes
- Provider reconsiderationFile within 180 days
General reconsideration window measured from the initial claim decision. State exceptions apply; some clinical, utilization-review and other disputes go directly to appeal.
- Appeal after reconsiderationFile within 60 days
Measured from the reconsideration decision, not the original service date. Direct-to-appeal disputes, Medicare non-contracted providers and state exceptions have separate requirements.
Source: Aetna provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Aetna
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Aetna accepts X12 278 prior-authorization transactions electronically. The procedures most commonly subject to prior authorization include advanced imaging, inpatient admissions, specialty pharmacy, and certain outpatient surgical procedures. Use the payer's authorization tool below to confirm requirements per CPT before scheduling a service.
Aetna maintains a live prior-authorization code lookup tool that supersedes any cached list. Use the provider portal or the policy documents below to confirm the current PA list before rendering a service.
Top denial reasons for Aetna
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Aetna volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Supported | Payer ID |
|---|---|---|
| 837P / 837I claims | Yes | 60054 |
| 270 / 271 eligibility | Yes | 60054 |
| 278 prior authorization | Yes | Verify X12 278 routing separately |
| 835 ERA | Yes | 60054 |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The specific findings below were compared with public primary sources on . This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
Initial filing deadline
The state supplement's New York section describes a 120-day initial-claim window, subject to more favorable agreements or different legal requirements. It does not establish one national deadline.
Primary source for initial filing deadlineProvider disputes and contact routing
Aetna describes reconsideration within 180 calendar days of the initial decision and appeal within 60 calendar days of the reconsideration decision. Some disputes bypass reconsideration. Its non-Medicare contact is 1-888-632-3862; Medicare uses 1-800-624-0756.
Primary source for provider disputes and contact routingState exceptions
Aetna lists state-specific exceptions for fully insured plans. Identify the state, product and dispute type before using its general filing standard.
Primary source for state exceptions
Not checked in this pass: Enrollment totals; Every payer ID and transaction; Every state or employer contract; QuickIntell integration or customer outcomes.
QuickIntell coverage for Aetna
Frequently asked questions about Aetna
Where is the Aetna provider portal?
The Aetna provider portal is available at https://www.aetna.com/health-care-professionals.html. Use it for eligibility checks, claim status, prior authorization workflows, appeals, and payer-specific routing updates. QuickIntell links to the payer's provider-facing portal as a reference and is not the official payer portal.
What is the timely filing limit for Aetna?
Aetna's New York state supplement describes 120 days after service for initial claims, unless a more favorable agreement or a different legal requirement applies. This is not a national participating-provider deadline. Confirm the member's product, state and provider agreement before calculating the filing date.
What is the Aetna payer ID?
The registry lists claims payer ID 60054 for Aetna. Eligibility (270/271): 60054. ERA (835): 60054. Do not substitute a claims ID for an unverified transaction ID. Confirm the member ID card, product and clearinghouse payer list before submitting.
Does Aetna accept electronic claims?
Yes — Aetna accepts ANSI X12 837P and 837I electronic claims through standard clearinghouses. Real-time eligibility (270/271) is supported and X12 278 prior authorization is supported.
How do I appeal a Aetna denial?
Identify the product, state and reason for the decision before choosing a Aetna dispute route. The listed starting route is Provider reconsideration (File within 180 days). General reconsideration window measured from the initial claim decision. State exceptions apply; some clinical, utilization-review and other disputes go directly to appeal. Verify the controlling notice and exceptions; reconsideration, appeal and external review are not always a mandatory sequence.
How long do Aetna prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Aetna provider phone number?
This registry lists 1-888-632-3862 as a provider contact for Aetna. Confirm the service scope and the number on the member ID card; claim, eligibility and authorization inquiries may use different teams. Have the member ID, date of service and tax ID ready. The provider portal is https://www.aetna.com/health-care-professionals.html.
Automate workflows around Aetna requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Aetna's current published documents before submission. CPT® is a registered trademark of the American Medical Association.