CommercialAdministrativeMedium impact
June 2025 newsletter
Aetna·Newsletter
Effective date
Sep 1, 2025
We identified it
May 3, 2026
Summary
Aetna's June 2025 newsletter announces new claim edits under the Claim and Code Review Program starting September 1, 2025, affecting all commercial, Medicare and Student Health members. The update also emphasizes proper Epic EHR lab result submission and requires providers to verify their directory information to avoid removal.
Action Required
By September 1, 2025: Billing team must review new claim edits on Availity portal for CCRP updates affecting commercial, Medicare and Student Health claims. Providers using Epic EHR must ensure lab draw appointments convert to correct encounter types using Encounter Conversion function. All providers must verify profile information in Provider Data Management tool on Availity to avoid directory removal.