MedicaidAdministrativeMedium impact
Quick Reference Guide
Aetna Better Health of Virginia·VA·Provider Notification
We identified it
Aug 13, 2026
Summary
Aetna Better Health of Virginia released an updated Quick Reference Guide consolidating provider contact information, claims submission requirements, prior authorization procedures, and specialty service contacts. This is a reference document clarifying existing processes rather than introducing new billing policies, but the 3-day-old status warrants review for any workflow confirmations or contact updates that may affect current practice operations.
Action Required
Immediately: Billing team should review and update internal contact lists and workflow documentation with the following critical information: (1) Confirm claims submission timely filing limit is 365 calendar days from date of service or discharge—claims submitted after this deadline will be denied; (2) Verify that all electronic claims are submitted using EDI payer ID 128VA through Office Ally (free) or authorized clearinghouses; (3) Update prior authorization submission fax numbers for Legacy M4 (866-669-2454), Legacy Plus (855-661-1828), and Behavioral Health (833-757-1583); (4) Ensure all claims include member name, DOB, ID number, service/admission date, treatment location, service/procedure description, NPI, and DMAS-enrolled taxonomy; (5) Brief front desk staff that members must call MediDrive at 1-800-734-0430 at least three days before appointments to arrange covered transportation; (6) Update staff on new Online Prior Authorization Search Tool for checking code-level PA requirements; (7) Update provider portal links and pharmacy contact information in internal systems. Document the new email addresses: AetnaBetterHealth-VAProviderRelations@Aetna.com (provider relations), AetnaConsumerDirection@Aetna.com (consumer direction), and reportfraudabuseva@aetna.com (fraud reporting). Failure to meet the 365-day claims filing deadline will result in automatic claim denials.