Aetna

Aetna Provider EDI Connectivity

HIPAA X12 electronic data interchange for health care professionals - EDI 837 claims, 270/271 eligibility and benefits, 276/277 claim status and 835 remittance advice. This is not an Aetna-hosted REST API and Aetna publishes no machine-readable contract for it; connectivity runs through the Availity provider portal and through clearinghouses, against the ASC X12 5010 and NCPDP D.0 transaction standards Aetna documents on aetna.com.

GitHub

Documentation

📖
Documentation
https://www.aetna.com/health-care-professionals/claims-payment-reimbursement/electronic-claims.html

Other Resources

🔗
Portal
https://www.aetna.com/health-care-professionals/availity.html
🔗
Conformance
https://www.aetna.com/health-care-professionals/icd-10-5010-npi-information/5010-d0-transaction-standards.html

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API entry from apis.yml

apis.yml Raw ↑ 
aid: aetna-provider-edi-api
name: Aetna Provider EDI Connectivity
description: HIPAA X12 electronic data interchange for health care professionals - EDI 837 claims, 270/271
  eligibility and benefits, 276/277 claim status and 835 remittance advice. This is not an Aetna-hosted
  REST API and Aetna publishes no machine-readable contract for it; connectivity runs through the Availity
  provider portal and through clearinghouses, against the ASC X12 5010 and NCPDP D.0 transaction standards
  Aetna documents on aetna.com.
humanURL: https://www.aetna.com/health-care-professionals/availity.html
baseURL: https://www.availity.com
tags:
- EDI
- X12
- HIPAA
- Claims
- Eligibility
- Remittance
- Availity
- Clearinghouse
properties:
- type: Documentation
  url: https://www.aetna.com/health-care-professionals/claims-payment-reimbursement/electronic-claims.html
- type: Portal
  url: https://www.aetna.com/health-care-professionals/availity.html
- type: Conformance
  url: https://www.aetna.com/health-care-professionals/icd-10-5010-npi-information/5010-d0-transaction-standards.html