Aetna
Aetna Health, Inc. / Aetna Life Insurance Company · CVS Health Corporation · NAIC 78700
Where to send the appeal
Verified addresses and inbound channels. We refresh on every release.
Response timeline
The clocks that matter. Miss them and you escalate to the state insurance commissioner.
Codes worth fighting
Based on outcome data across our payer corpus.
- CO-97
- CO-18
- CO-4
- CO-167
- CO-204
- CO-50
- CO-29
- PR-1
Modifier behavior
The denials this payer applies on modifier-bearing claims. The rebuttal language is part of the Denial OS letter generator and not published here.
Modifier 25
Significant, Separately Identifiable E/M ServiceAetna's claims engine applies tighter documentation requirements on modifier 25 than CMS baseline. Frequently denied as CO-4 or CO-97.
Modifier 59
Distinct Procedural ServiceNCCI-compliant modifier 59 use sometimes denied as CO-97 bundle when paired with same-day same-region services.
Modifier GP
PT plan of care servicesAetna requires GP modifier on outpatient PT services for proper claim adjudication.
Interest statute
The legal basis for charging interest when payment runs late.
Varies by state — CA Insurance Code §10123.13 / TX Insurance Code §1301.103 / NY Insurance Law §3224-a / FL Statute §627.6131 / WA WAC 284-43-321
You have the playbook. Now write the letter.
Paste your EOB and Denial OS generates the appeal in five minutes — citing the contracted rate, the modifier rebuttal, and the deadline statute that matches this exact payer.
Start your appeal