This is my first time posting, so I hope I’m in the right forum and also not repeating someone else’s question.

This question is specifically for Aetna in Texas but any feedback is appreciated.

I am getting no where fast when trying to get reimbursement from Aetna for Televisits. I’ve coded it all kinds of ways: POS 2 no modifiers, POS 2 modifier GT, and POS 2 modifier 95.

Every claim is being denied for various reasons: (1) Missing/incomplete/invalid/inappropriate place of service, (2) Procedure code incidental to primary procedure, and/or (3) Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. (and a few other denials… basically all meaning the same thing)

What makes it worse is that every Aetna provider rep I get on the phone tells me something different. A lot of overseas reps will just default to "appeal and send records," but I cannot do that for EVERY Aetna televisit! Does anyone know what Aetna’s deal is? What is the best way to bill televisits for Aetna members?

Thank you in advance for your input!
-Brennen