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Aetna Precert and Admission Notification Rejections

This morning Aetna sent out the announcement below regarding some issues they’re having with their EDI transactions for precert and notifications. If you get a rejection with one of the codes listed below, please call the precert number on the members ID card to complete your precert request.

Purpose:

We’d like to let you know we’re rejecting some Precertification Add and Notification transactions, but we’re not returning all the rejection reasons.

Overview:

We’re currently rejecting some Precertification Add and Notification transactions, but we’re not returning all the rejection reasons. Certain transactions are rejecting with the following two codes:

  • A3: Not Certified
  • 25: Services were not considered due to other errors in the request.

Our systems aren’t returning additional rejection reasons, so we’re unable to determine the exact reason for the rejected transactions. For some rejected transactions, we’ve determined there are duplicate requests.

This issue:

  • Is affecting requests initiated on all vendor partner websites
  • Isn’t limited to certain plan types
  • Isn’t affecting all Precertification Add and Notification transaction requests

We’re researching this issue at a high priority, but we don’t have a resolution date yet. We’ll send an update once we have additional information.

Aug 8, 2019Payer Goddess
Current Medicare HETS Eligibility IssuesMBI Transition Period Coming to an End

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