Becker's Healthcare August 6, 2025
Aetna is rolling out a new inpatient reimbursement policy for its Medicare Advantage and Special Needs Plans, effective Nov. 15.
“Our goal is simple: We want to help you get reimbursed faster for inpatient admissions that are initially denied. You’ll receive faster payment and still be allowed to appeal for a higher payment,” the insurer wrote in an August update to providers.
Six things to know:
1. The policy applies to urgent or emergent hospital admissions for Medicare Advantage and SNP members that span at least one midnight. It does not apply to stays under one midnight, which remain subject to standard CMS medical necessity reviews.
2. For eligible stays, Aetna will automatically approve the inpatient admission without requiring a...
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