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Aetna OhioRise Medicaid Managed Care Entity

Aetna OhioRise Medicaid Managed Care Entity

This page contains information you can use to exchange healthcare transactions with Aetna OhioRise Medicaid Managed Care Entity using Stedi.
Use any of the following payer IDs to send transactions to Aetna OhioRise Medicaid Managed Care Entity using Stedi APIs or SFTP. Read the docs
Primary Payer ID
45221
Stedi Payer ID
SIQAQ
Payer ID aliases
14387, 45221, 9435, OHRISE
Coverage types
Medical

Supported transactions

Use Stedi to exchange the following transactions with Aetna OhioRise Medicaid Managed Care Entity using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Aetna OhioRise Medicaid Managed Care Entity.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Aetna OhioRise Medicaid Managed Care Entity to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to Aetna OhioRise Medicaid Managed Care Entity in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to Aetna OhioRise Medicaid Managed Care Entity and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Aetna OhioRise Medicaid Managed Care Entity and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Aetna OhioRise Medicaid Managed Care Entity to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to Aetna OhioRise Medicaid Managed Care Entity and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Aetna OhioRise Medicaid Managed Care Entity.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Aetna OhioRise Medicaid Managed Care Entity and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Aetna OhioRise Medicaid Managed Care Entity today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • Aetna OhioRISE Medicaid Managed Care Entity
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