AETNA
Aetna Healthcare Policy Updates and Provider Information
Important Policy Updates
Claim and Code Review Program (CCRP) Update
Beginning Sept. 1, 2025, healthcare providers will encounter new claim edits as part of Aetna’s Claim and Code Review Program. These updates will affect both commercial and Medicare members and are designed to improve claim processing accuracy across commercial, Medicare, and Student Health plans.
Providers can access these edits through the Aetna provider portal on Availity by navigating to Aetna Payer Space > Resources and searching for “expanded claim edits.” Code edit lookup tools are available for all plans except Student Health, requiring providers to use their Aetna provider ID number (PIN) for access.
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