Aetna Payment Estimator for Doctors Helps Improve Patient Satisfaction and Cash Flow

-- In a recent survey of estimator users, 65% of medical offices reported a reduction in bad debt --

HARTFORD, Conn.--(BUSINESS WIRE)-- The Aetna Provider Payment Estimator has become an everyday resource at many medical offices across the country. In fact, nearly 350,000 estimates have been generated by doctors since the tool launched a year ago. The online tool gives doctors an instant estimate of what Aetna will pay and what the patient will owe for services delivered.

Aetna recently asked 100 estimator users, including office managers and billing managers/specialists, about the tool. The majority responded that the tool:

  • Offers the ability to provide accurate estimates to patients
  • Improves customer service and patient satisfaction
  • Increases payments and reduces unpaid bills

“We created the payment estimator to help doctors provide reliable estimates to patients. More and more employers are offering health plans that give employees more control and responsibility for their health care dollars. Because many members now have a larger share in medical costs, patients and their doctors need to know what will be owed before or when a visit or procedure occurs,” said Chere Parton, head of Aetna Provider eSolutions.

Estimates are available for professional services such as office visits and medical procedures. The tool also estimates outpatient facility services and select inpatient hospital services. The estimates are processed directly in Aetna’s claims system, not from historical data.

Using the tool, doctors can offer payment options up front, especially for high-cost services. Members can more easily use their Health Savings Account (HSA) debit cards because these individuals will know the amount to be debited at the time of service.

“As an office manager at a small surgical facility, I am always looking for ways to streamline administrative processes and clearly explain to patients the cost of care,” said Samantha Johnson at Doylestown Surgical Center in Pennsylvania. “We’ve been using the payment estimator for about a year. The estimator tool is an excellent help when discussing insurance coverage with our patients. The tool provides clear, easy-to-understand information about what is covered and how much the patient will owe out of pocket. The tool also helps us to answer questions about costs right away, rather than waiting for the claim to be processed.”

The estimator is available on Aetna’s secure provider website via the NaviNet® health care communications network. All doctor offices and hospitals that participate in Aetna’s network have access to the tool.

The provider resource is complemented by a tool for Aetna members. Members can use the Aetna Member Payment Estimator to get detailed estimates for hundreds of commonly used, non-emergency health care services. Unlike other pricing tools, Aetna’s cost estimate is created from the same system that pays the actual claim. Real-time estimates are based on the member’s actual plan design and Aetna’s negotiated rates with providers. The level of detail – a first for health plan members – helps individuals better plan for and budget for health care.

About Aetna

Aetna (NYSE: AET) is one of the nation’s leading diversified health care benefits companies, serving approximately 33.8 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see To learn more about Aetna’s innovative online tools, visit


Stephanie Ancillai, 860-273-8447
[email protected]

KEYWORDS:   United States  North America  Connecticut

INDUSTRY KEYWORDS:   Practice Management  Health  Hospitals  Professional Services  Finance  Insurance  Managed Care