Please find important forms related to the myNEXUS Claims Process listed below.Įlectronic Funds Transfer (EFT) Enrollment: myNEXUS offers EFT payment options for providers. The myNEXUS payer ID for the Aetna delegation is: 34010. This document explains the IV therapy program in detail. Home Infusion (IV) Therapy: IV Therapy Information: myNEXUS is not delegated for IV Therapy. Re-Authorization Request Form:Fax form to use for re-authorization requests if needed.įax Confirmation Form: Online form providers use to confirm their fax numbers for authorization requests Initial Authorization Request Form:Fax form to use for initial authorization requests if needed. The Provider Portal can be found online here.

In-Scope Plans: In-Scope Plan List: The list of in-scope Aetna plans for the myNEXUS delegation.Īuthorization Requests: myNEXUS Provider Portal: myNEXUS encourages providers to utilize the online Provider Portal to submit authorization requests. Please complete the “Agency Information Form” to have your agency’s information added to the myNEXUS system. A recording of a previous session can be found in the myNEXUS Provider Portal or by emailing Information Form: Orientation Sessions: Orientation training sessions have now ended.Notice: The delegation notice and orientation letter mailed and emailed to agencies is available here.Delegated services include Utilization Management, Network Management, and Claims Reimbursement. Delegation: Effective July 1st, 2022, myNEXUS began managing Aetna Medicare Advantage (MA) plans in the states of Pennsylvania and West Virginia.

Current Announcements: PA & WV July 1st, 2022 Delegation Information:

Please find important announcements, documents, and forms listed below. Please let me know if anything needs to be updated or add any insurance timely filing limits in the comments box below.MyNEXUS is proud to announce its partnership with Aetna to provide utilization management for home health services in Georgia, Kentucky, Missouri, Ohio, Oklahoma, Pennsylvania, Texas, Virginia, and West Virginia. In this post you have seen Aetna timely filing limit, Medicare, BCBS and Cigna timely filing limit. Time frame usually depends on the insurance company and above is the list of timely filing limits of all insurance companies. So it is better to know the time frames to submit the initial claims within a time frame. If suppose claims submitted after the time frame from the DOS, claims will be denied as untimely filing. It is calculated from the date service provided. It is the time limit set by the insurance companies to submit the initial claims for the services rendered to their subscribers. Timely Filing Limit for all Insurances 2019ĩ0 Days for Participating Providers or 12 months for Non Participating ProvidersīCBS timely filing for Commercial/Federalġ80 Days from Initial Claims or if its secondary 60 Days from Primary EOBĩ0 Days for Participating Providers or 180 Days for Non Participating Providersġ80 Days for Physicians or 90 Days for facilities or ancillary providers Timely filing limits for some of the important insurances like Aetna timely filing limit, Medicare timely filing, BCBS timely filing, UHC, Cigna timely filing limits and many more in the following table.

Aetna medicare timely filing limit 2021