MedicaidAdministrativeMedium impact
Implementing SNIP Type 4 Edits and Enhancing Claims Intake Editing at Types 1 – 4
Aetna Better Health of Virginia·VA·Reimbursement
Effective date
Oct 11, 2024
We identified it
Aug 13, 2026
Summary
Aetna Better Health of Virginia is implementing enhanced SNIP Type 4 edits (and enhancing Types 1-3) to validate electronic claims submissions for proper EDI formatting and HIPAA compliance. This automated validation process will reject non-compliant claims at intake to reduce rework and improve clean claim rates. No provider workflow changes are required.
Action Required
By October 11, 2024: Billing team should verify that all claims submissions to Aetna Better Health of Virginia comply with HIPAA EDI standards, specifically Type 4 inter-segment logic (conditional requirements such as accident date presence when accident is indicated). No system changes are required from providers. Monitor for any claim rejections related to missing conditional data elements and update claim submission processes if needed. Ensure all claims contain required conditional segments per HIPAA implementation guide specifications. Contact Provider Relations at 1-800-279-1878 (TTY: 711) with questions about claim submission format compliance.