CommercialAdministrativeMedium impact
OfficeLink Updates - September 2024 newsletter
Aetna·CA, ID, IL, NJ, NC, OR·Newsletter
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Aetna Passport to Healthcare members may show as ineligible in EDI 270/271 transactions, but providers must call the phone number provided instead of turning members away. Immunization/vaccine coding changes scheduled for March 2024 have been cancelled, and pharmacist reimbursement changes take effect January 1, 2025.
Action Required
Immediately: Train front desk and billing staff to call the phone number displayed in EDI transactions for Aetna Passport to Healthcare members (group numbers starting with 8639 or 1493) instead of denying eligibility. Never tell members Aetna doesn't cover them. By January 1, 2025: Update billing procedures to apply Mid-Level and Other Qualified Health Care Professional payment policy to pharmacist providers in applicable states.