Payer Directory

How to check Aetna OhioRISE Medicaid Managed Care Entity eligibility

A portal or phone check takes a front-desk staffer 10–15 minutes per patient. A real-time 270/271 check returns plan status, copays, deductibles, and out-of-pocket maximums in seconds.

  • Payer ID 45221
  • Real-time 270/271
  • Medicaid

Three ways to verify Aetna OhioRISE Medicaid Managed Care Entity coverage

  1. Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
  2. Phone (IVR) — hold times vary; no written record for the chart.
The third way

Automated 270/271 check

Full benefit detail in seconds, batched for your whole schedule — not one patient at a time.

From $0.50 per check, pay-as-you-go.

Payer facts

Aetna OhioRISE Medicaid Managed Care Entity at a glance

What billers need before running a check.

  • Payer ID

    45221Also known as 14387, 9435, OHRISE

  • Real-time eligibility

    AvailableResponses return in seconds, 24/7.

  • Coverage

    medical, visionMedicaid

  • Operating area

    Ohio

  • Payer website

    www.aetnabetterhealth.com
Transactions

Supported transactions

What can be exchanged electronically with Aetna OhioRISE Medicaid Managed Care Entity today.

  • Eligibility (270/271)

    SUPPORTEDReal-time benefit and coverage checks

  • Claim status (276/277)

    SUPPORTEDWhere a submitted claim stands

  • Professional claims (837P)

    SUPPORTEDPhysician and outpatient claims

  • Institutional claims (837I)

    SUPPORTEDFacility claims

  • Dental claims (837D)

    NOT AVAILABLEDental claims

  • Remittance (835 ERA)

    ENROLLMENT REQUIREDElectronic remittance advice

  • Coordination of benefits

    NOT AVAILABLESecondary-payer routing

  • Claim attachments (275)

    NOT AVAILABLESupporting documentation
Compare

Portal vs. phone vs. automated

The same verification, three ways.

MeasurePayer portalPhone / IVRAutomated check
Time per patient10–15 min15–30 minSeconds
Cost per checkStaff time, one login per patient~$8.57 in staff time*from $0.50
Record for the chartScreenshotNoneFull audit trail
Whole-day scheduleOne at a timeOne at a timeBatched overnight

*A manual eligibility check costs a medical practice $8.57; an electronic one costs $2.00. Source: 2024 CAQH Index.

In production

What Medman does in practices today

  • 65%

    fewer denials at Valley Diabetes & Obesity

  • 90%

    of eligibility checks fully automated

  • $107–149K

    annual savings, small specialty practice

  • 24 mo

    in production

Questions

Frequently asked questions

What is the payer ID for Aetna OhioRISE Medicaid Managed Care Entity?

Aetna OhioRISE Medicaid Managed Care Entity uses payer ID 45221. It also appears as 14387, 9435, OHRISE in some systems.

Does Aetna OhioRISE Medicaid Managed Care Entity support real-time eligibility verification?

Yes. Aetna OhioRISE Medicaid Managed Care Entity accepts real-time 270/271 eligibility transactions, so a check returns plan status and benefit detail in seconds instead of the 10–15 minutes a portal login takes.

How long does a Aetna OhioRISE Medicaid Managed Care Entity eligibility check take?

A portal check takes 10–15 minutes of staff time per patient. An automated real-time check returns in seconds and can run for an entire day's schedule overnight.

Directory

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Run your first Aetna OhioRISE Medicaid Managed Care Entity eligibility check

From $0.50 per check, pay-as-you-go. No annual contract, no implementation project.

How the eligibility agent worksSee pricing

Billing more than Aetna OhioRISE Medicaid Managed Care Entity? — upload it and see which of your payers run automatically.