MedicaidAdministrativeMedium impact
Provider Notification - Understanding Reversal Payments
Aetna Better Health of Virginia·VA·Provider Notification
We identified it
Aug 13, 2026
Summary
Aetna Better Health of Virginia is clarifying its reversal payment process for third-party liability recoveries under Medicaid. When a third-party payer is identified as primarily responsible, Aetna recovers payment from that payer and reprocesses claims to show net-zero impact to providers—meaning providers retain their original payment and see offsetting adjustments on remittance statements, not actual refunds.
Action Required
Immediately: Billing team must educate all staff on the third-party liability reversal process to prevent confusion when net-zero adjustments appear on Aetna Better Health of Virginia remittance statements. When reversal claims are reprocessed: (1) Verify that positive and negative line items on the remit equal zero dollars; (2) Do NOT refund patients or providers—the net-zero result means no money is recouped; (3) Retain documentation of third-party payments received by Aetna; (4) Respond promptly to any Aetna requests for supporting documentation. Update billing team training materials and remittance review procedures to recognize this pattern. Failure to understand this process may result in incorrect payment adjustments or unnecessary follow-up with Aetna.