MedicaidAdministrativeMedium impact
Provider Notification - SNIP Types 5 and 6 Enhanced Editing Implementation Update
Aetna Better Health of Virginia·VA·Policy Update
Effective date
Jun 23, 2026
We identified it
Aug 13, 2026
Summary
Aetna Better Health of Virginia is implementing enhanced SNIP Types 5 and 6 editing through the Edifecs Smart Trading platform for Medicaid claims, effective June 23, 2026. These additional validations will check external code sets (ICD-10-CM, CPT/HCPCS, NDC) and healthcare service-specific line items before claim acceptance, reducing downstream rejections and accelerating adjudication. Provider claim submission processes remain unchanged, but claims will face stricter upfront validation rules.
Action Required
By June 23, 2026: Billing team should conduct an internal audit of current claim submissions to Aetna Better Health of Virginia Medicaid to identify potential formatting or code validation issues that may be caught by the new SNIP Types 5 and 6 edits. Review claims for: (1) proper ICD-10-CM diagnosis code usage, (2) valid CPT/HCPCS procedure codes, (3) correct NDC code formatting where applicable, and (4) appropriate line-item segmentation for specialized services (e.g., ambulance, chiropractic). No immediate software changes are required since provider submission processes are not affected. Monitor for claim rejection patterns after the effective date and contact Aetna Provider Relations at 1-800-279-1878 (TTY: 711) if questions arise regarding specific rejections. Failure to align with these enhanced validations may result in increased claim rejections and delayed reimbursement.