Sept Industry Notes: Aetna Payment Delays

Oklahoma: Aetna Better Health Payment Delays 

Aetna Better Health Oklahoma is denying claims in error with the following denial codes: 

• MA04 – SECONDARY PAYMENT CANNOT BE CONSIDERED WITHOUT THE IDENTITY OF OR PAYMENT INFORMATION FROM THE PRIMARY PAYER. THE INFORMATION WAS EITHER NOT REPORTED OR WAS ILLEGIBLE. 

• N4 – MISSING/INCOMPLETE/INVALID PRIOR INSURANCE CARRIER(S) EOB 

• 252 – AN ATTACHMENT/OTHER DOCUMENTATION IS REQUIRED TO ADJUDICATE THIS CLAIM/SERVICE.  

This is a known issue with Aetna that is causing high rates of denial. While Aetna is working on a resolution, they do not have an estimate on when this work will be completed.  Aetna will reprocess claims once a fix is in place. Claims should not be resubmitted.