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What is Payer ID 60054? A Simple Guide for Healthcare Billing

Stanley Efrem

Jun 25, 2025

Rejected healthcare claims due to wrong 60054 payer ID information can delay your payments and create needless administrative hassles. Every insurance company's electronic claims system needs its own unique payer ID number to process submissions successfully.

A payer ID serves as a specific identifier that insurance companies use to process electronic claims. To cite an instance, Aetna's payer ID 60054 works with any clearinghouse. National payers like Aetna (60054), Cigna (62308), and United Healthcare (87726) use the same payer IDs with all clearinghouses. But filing mental health insurance claims needs careful verification of the right payer ID information.

This piece covers everything about payer ID 60054, its proper use with Aetna claims, and steps that ensure smooth processing of your submissions without delays.

What is a Payer ID and why it matters in billing

Healthcare billing systems depend on unique identifiers that will give claims a clear path to their destination. The right identifiers can make the difference between quick payments and frustrating delays.

Definition of a payer ID

A payer ID works as a unique alphanumeric code that insurance companies and healthcare payers use to process electronic claims. These codes are five characters long [1] and can include letters, numbers, or both [1]. You can think of payer IDs as special "addresses" in the digital claims world that guide your submissions to the right insurance company.

Major insurers use their own unique codes. Aetna's payer ID is 60054, while Optum uses 87726 [2]. These identifiers work just like postal codes to make sure your claim reaches the right processing center.

You'll find payer IDs on insurance cards' back side in the Provider or Claims Submission section [1]. Sometimes you might need other methods to verify them if this information isn't readily available.

How payer IDs are used in electronic claims

Payer IDs guide claims through the electronic submission process. Your Electronic Health Record (EHR) system or billing software uses these IDs to send claims to the right insurance company's processing system [3].

These identifiers serve vital roles in the claims process:

Accurate routing: Claims reach the right payer directly [4]
Efficient communication: Providers and insurance companies can work together smoothly [4]
Claim tracking: Better monitoring of submission status becomes possible [4]
Contract management: Claims connect to the right payer contracts [4]

Clearinghouses rely on payer IDs as their main tool to route claims [5]. Your claim will reach its destination if the payer ID is correct, even when other details vary. This makes verifying the correct payer ID before submission absolutely necessary.

Why payer IDs are essential for mental health billing

Mental health providers need to pay special attention to payer IDs. Insurance companies often use different payer IDs for medical and behavioral health services [6]. This adds complexity to the billing process.

The right payer IDs in mental health billing help:

Direct claims to the correct behavioral health platform [6]
Process claims under mental health-specific rules
Get payments on time [7]

Behavioral health practitioners must verify their payer IDs carefully. Experts say that "selecting the right payer ID to use when filing your mental health insurance claims is a matter of spending the time asking about which payer ID to use".

Providers should verify payer IDs before seeing new clients. This early check confirms both the payer ID and the patient's service eligibility. Double-check this information with your clearinghouse provider (like OfficeAlly) before submitting claims.

Wrong payer IDs can send claims off course, causing delays or rejections [3]. Mental health providers already face complex reimbursement challenges. Getting these details right from the start helps maintain steady cash flow and reduces paperwork.

Understanding Payer ID 60054: Aetna’s Identifier

The healthcare system needs providers to know specific codes for each insurance company. Aetna, a major U.S. health insurer, has its own code that providers must use to process claims correctly.

What is Aetna payer ID 60054?

Aetna's unique electronic identifier for processing healthcare claims is payer ID 60054. This five-digit code works like a digital address that sends your electronic claims straight to Aetna's systems. The code 60054 is Aetna's standard identifier that works with every clearinghouse in the country.

Payer ID 60054 acts as a routing number in the electronic claims system. Your claims will reach Aetna's processing center directly when you submit them through your practice management system or clearinghouse. The code stays the same no matter which clearinghouse you pick - OfficeAlly, Availity, or any other platform.

Submitting claims electronically with the right payer ID is nowhere near as time-consuming as paper claims. You'll get faster processing, lower costs, and better tracking options. Yes, it is true that using payer ID 60054 the right way will make your Aetna claims much smoother.

When to use payer ID 60054

Here's when you should use payer ID 60054:

Standard Aetna medical plans: This ID works for patients with traditional Aetna health insurance
Aetna Better Health plans: The 60054 code is right for Aetna's Medicaid managed care
Aetna Medicare Advantage: Medicare Advantage claims need this ID
Behavioral health services: Aetna uses the same 60054 code for mental health claims, unlike other insurers

In spite of that, all but one of these cases use the 60054 code. Some Aetna subsidiaries and special programs might need different codes. That's why checking before you submit is vital, especially with new patients or unusual plans.

The address for claims tied to payer ID 60054 changes based on what type of claim it is and where you are. Electronic submissions automatically go to the right processing center. Paper claims need a specific mailing address, which you can find through Aetna's provider portal or representative.

Common plans associated with 60054

Most Aetna insurance products use the 60054 payer ID system, including:

Aetna Choice POS plans - Plans that mix HMO and PPO features
Aetna Select plans - Network-based HMO and EPO plans
Aetna Medicare plans - These include Medicare Advantage and Medicare Supplement
Aetna Signature Administrators - Employer plans that Aetna manages
Aetna Better Health - Medicaid managed care plans in different states

Many employer health plans that Aetna manages use this same code. This includes both fully-insured and self-funded plans where Aetna acts as the administrator.

The 60054 payer ID covers most of Aetna's business. Healthcare practices should know this code well since Aetna has such a big share of commercial and government insurance programs. Most practices handle many claims that need this payer ID.

Always check the coverage and correct payer ID through Aetna's provider portal or call the number on your patient's insurance card before submitting claims. This extra step might take time but prevents rejected claims and delayed payments.

How to verify the correct payer ID for a patient

Getting the right payer ID needs a step-by-step check that removes any guesswork and stops claims from being rejected. This becomes really important if you work with multiple insurance plans or new payers like Aetna with payer ID 60054.

Step-by-step guide to eligibility verification

Insurance eligibility checks need more than just coverage confirmation—you need the exact electronic routing details. Here's a complete process:

Collect complete patient information first, including full name, date of birth, insurance ID, group number, and contact details. Check multiple data points to avoid errors.
Contact the insurance provider through their online portal or phone system. You should start eligibility checks 48-72 hours before scheduled services.
Confirm policy status and coverage details including active policy status, covered services, and pre-authorization requirements.
Request the specific payer ID to submit electronic claims. You'll find the payer ID on insurance cards' back side in the Provider or Claims Submission section.
Document verification results with the insurance representative's name and call reference ID.

Using phone scripts to confirm payer ID

A well-laid-out script helps you get all needed information during insurance company calls:

Start with "I'm looking to verify eligibility and benefits for a new patient for Outpatient Mental Health Provider services." Next, check if you're an in-network provider and make sure your office address matches their records.

Give the patient's details and ask "What is the Payer ID for electronic claims?" This direct question usually gets you the exact ID.

End your call with "Thank you for your help, can you please provide your name and a reference ID for this call for my records?" This creates a paper trail for future reference.

Cross-checking with clearinghouse databases

Your clearinghouse partner offers another verification point. After getting a payer ID (like 60054 for Aetna), check it against your clearinghouse's database:

Go to your clearinghouse's website (like OfficeAlly: https://cms.officeally.com/Pages/ResourceCenter/PayerLists/PayerList.aspx)
Look up the payer ID from your eligibility verification call
Try searching by insurance company name if the payer ID search shows no results
Reach out to clearinghouse support if you find differences between insurance company information and database listings

This process helps prevent claims from going to wrong places, which would cause delays and rejections. Checking the electronic "address" before submission increases your chances of getting paid on time.

Working with clearinghouses to submit claims

Healthcare billing moves through specialized middlemen that make sure your claims get to their destination without getting pricey detours or delays.

What is a clearinghouse?

Think of a clearinghouse as a digital bridge connecting your practice to insurance companies like Aetna. These third-party organizations collect, screen, and send electronic claims. They act as quality control gatekeepers before submissions reach payers. You can submit claims to multiple insurance companies through a single platform instead of visiting each payer's website. This becomes especially helpful as your practice grows.

Your claims go through several vital steps at the clearinghouse. The system verifies HIPAA compliance, checks for errors, and adjusts submissions to meet specific payer requirements. This screening catches mistakes early. Missing digits, wrong birthdate formats, or invalid payer IDs get flagged before reaching insurers.

How clearinghouses verify payer IDs

Clearinghouse systems carefully check payer ID accuracy during claim review. Wrong payer IDs cause most claim rejections. To cite an instance, if you type any ID other than 60054 for Aetna, the clearinghouse systems flag this error before transmission.

The verification process checks if the payer ID:

Exists and is complete
Remains active
Links to the right insurance carrier
Fits the specific claim type

Therefore, these systems prevent providers from sending claims to the wrong insurance company due to incorrect identifiers.

Using OfficeAlly or other platforms to confirm 60054

Popular clearinghouses like OfficeAlly have complete payer databases that show Aetna's payer ID 60054 for claims submission. Here's how to confirm this ID in OfficeAlly:

Log into your OfficeAlly account
Go to their payer list section
Look for "Aetna" or type "60054"
Check that 60054 appears as the correct identifier for Aetna claims

OfficeAlly and similar platforms clearly show 60054 as the right payer ID for Aetna commercial health and Aetna Medicare plans. These systems then direct your electronic claims (837 files) to Aetna through secure HIPAA-compliant connections.

Submitting claims using payer ID 60054

The success of your claims processing depends on accurate entry and submission of the payer ID to get your reimbursements quickly.

How to enter payer ID 60054 in your EHR

You'll need to find the insurance information section in your EHR or practice management software. Most systems have specific fields for payer IDs. Enter "60054" to set up Aetna as a payer in your system. You should also differentiate between claims and encounters at the time of submitting to Aetna—use 60054 for standard Aetna claims processing.

Dental providers have a different system: use 60054 for Aetna claims and 68246 for Aetna DMO® plan encounters. This difference is significant because using the wrong identifier will delay processing.

Double-checking the Aetna payer ID 60054 claims address

Your electronic submissions with the 60054 payer ID will automatically go to the right processing center. You don't need a physical address for electronic claims.

Paper claims should be mailed to: Aetna PO Box 981106 El Paso, TX 79998-1106

Standard CMS-1500 or UB-04 forms are required for paper submissions. Remember to include the patient-paid amount on all claims and encounters you submit to Aetna.

Avoiding common submission errors

Your Aetna claims with payer ID 60054 might face delays due to these common issues:

Missing or invalid CDT procedure codes – Dental claims need a valid CDT procedure code
Duplicate submissions – Aetna will reject exact duplicates of electronic claims submitted within 180 days of the original
Enrollment form issues – Aetna stopped processing temporary paper ERA enrollment forms from the Change Healthcare service interruption since August 1, 2024

Electronic claims rejections can be resolved by calling the number on your EDI vendor's claims status report. Most problems are fixed by correcting missing or invalid information and submitting again electronically.

Conclusion

Payer ID 60054 plays a key role in processing Aetna claims correctly. In this piece, you'll learn about payer IDs, why they matter in healthcare billing, and how to use Aetna's specific ID the right way.

Healthcare billing can be overwhelming. But knowing how to use payer IDs like 60054 makes your reimbursement process smoother and cuts down on rejected claims. Note that Aetna uses this same ID with all clearinghouses across the country. This makes your billing work more predictable once you know the simple steps.

You must verify everything before sending any claim. Double-check the payer ID by talking to the insurance provider and looking it up in your clearinghouse database. This two-step check helps you avoid common submission mistakes.

Your practice software or EHR lets you save payer ID 60054 to process Aetna claims quickly. Claims sent electronically with the right payer ID get processed faster than paper ones. This improves your cash flow and reduces office work.

The digital world of healthcare billing keeps changing. Staying up to date with payer IDs and submission rules helps your office run smoothly. You might want to bookmark Aetna's provider portal or your clearinghouse's payer list for quick answers.

The right payer ID use affects your practice's bottom line directly. Claims sent to wrong places get delayed or rejected. This hurts your revenue cycle and creates extra work. Once you master this key part of medical billing, you'll see fewer rejected claims and faster payments from Aetna and other insurers.

FAQs

What is a payer ID and why is it important for healthcare billing?

A payer ID is a unique identifier assigned to insurance companies for processing electronic claims. It's crucial for accurate routing of claims, efficient communication between providers and insurers, and timely reimbursements. Using the correct payer ID helps avoid claim rejections and payment delays.

How do I find the correct payer ID for Aetna?

Aetna's universal payer ID is 60054. This identifier works across all clearinghouses nationwide for most Aetna plans, including standard medical, Medicare Advantage, and Aetna Better Health plans. Always verify this information through Aetna's provider portal or by calling their customer support before submitting claims.

Can I use payer ID 60054 for all types of Aetna claims?

While payer ID 60054 is used for most Aetna claims, including medical and behavioral health services, there may be exceptions for certain subsidiaries or specialized programs. It's best to verify the correct payer ID for each patient's specific plan before submitting claims.

How do clearinghouses help with payer ID verification?

Clearinghouses act as intermediaries between healthcare providers and insurance companies. They validate payer IDs, check for errors in claims, and ensure HIPAA compliance before transmitting to insurers. Platforms like OfficeAlly allow you to cross-check payer IDs in their databases for accuracy.

What should I do if my Aetna claim is rejected due to a payer ID issue?

If your claim is rejected due to a payer ID issue, first verify that you've entered 60054 correctly in your EHR or billing software. Then, contact the number provided on the claims status report from your EDI vendor. Most issues can be resolved by correcting any missing or invalid information and resubmitting the claim electronically.