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What you need to know about Aetna Signature Administrators®

Servicing an ASA member

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The ASA member ID card looks different from the ID card of someone enrolled in an Aetna health plan. The ID card includes the ASA logo and lists the administrator’s contact numbers for questions regarding eligibility, claims payment and claims status. The Explanation of Benefits statement also references ASA.

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Claims are processed and paid by the TPA. If you request a claim be re-evaluated due to a conflict in the contractual payment, the TPA will work with Aetna to resolve the issue.

Through Aetna Signature Administrators (ASA), we work with a small number of national third-party administrators (TPAs) that perform certain claims and customer service administrative functions for our mutual customers. These TPAs are required to meet specific standards and requirements and agree to follow appropriate policies and procedures.

Current ASA TPAs include: CoreSource/Trustmark UMR Principal Meritain Health n Allied Benefits n n n n

Updated: Aetna at a Glance

We recently updated Aetna at a Glance (AAG), our guide for physicians, hospitals and other health care professionals. This new version is intended to ease the administrative challenges that may arise for newly contracted health care providers.

AAG highlights:

n Aetna contact information Regional and local network information n

AAG is available in six regional versions and can be ordered online through our secure provider website. Once logged in, select “Aetna Health Plan” from the Plan Central home page, then “Communications” and “Mailings” (and search by state).

You can find more information about ASA on www.AetnaEducation.com. Refer to the “Products, Programs and Plans” subcategory of “Reference Tools.”

Aetna to purchase Horizon behavioral Services

Aetna has entered into an agreement to acquire Horizon Behavioral Services, LLC, a leading provider of Employee Assistance Programs (EAP) to many mid-sized and large employers.

Horizon Behavioral Services is the third-largest domestic provider of EAP services by membership with approximately 1,400 contracted employer clients representing over 13 million covered members in all 50 states and countries around the globe, and will be integrated into Aetna’s EAP business. Aetna will acquire Horizon Behavioral Services from its parent company, Psychiatric Solutions, Inc., the nation’s largest operator of owned or leased freestanding psychiatric inpatient facilities.

Horizon Behavioral Services provides unlimited 24/7 confidential telephonic consultation, comprehensive online employee assistance program and work/life resources and access to a referral network of more than 14,000 licensed clinicians.

SEPTEMBER 2009

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Tools, programs and resources available through our secure provider website via NaviNet

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Information on how to access our secure provider website

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Many of Aetna’s policies and procedures – such as Clinical Policy Bulletins, reimbursement policies and precertification requirements – apply to ASA.

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Claims turnaround time standards are the same as for those claims directly processed by Aetna.

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