Links to various non-Aetna sites are provided for your convenience only. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. *Address. 7 days a week, 24 hours a day. We ask for your phone number so we may call you to schedule an in-person appointment at a time thats convenient for you. We're here to help. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. In Pennsylvania, where competition is fierce, there are over 2.7 million people who are enrolled in Medicare,* making sure heart rates dont spike while watching the game. It is only a partial, general description of plan or program benefits and does not constitute a contract. [Narrator] Your child has an earache at 2:00 AM? ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. Then, have your visit within 72 hours from wherever you are. This information is neither an offer of coverage nor medical advice. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Copyright 2015 by the American Society of Addiction Medicine. Please report any scams by calling 1-800-447-8477 or online at https://tips.oig.hhs.gov/. They do not have access to member accounts but they can provide Aetna Member Services contact information. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). Copyright 2015 by the American Society of Addiction Medicine. With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. If you do not intend to leave our site, close this message. Select a state below to update coverage details. Links to various non-Aetna sites are provided for your convenience only. Applicable FARS/DFARS apply. We'll try our best to get back to you within 24 hours. Reprinted with permission. Web1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET.. Your InstaMed log-in may be different from your Caremark.com secure member site log-in. Please contact Medicare.gov or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Review the enrollment checklist with 4 to-do's before you choose a health plan. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. This site has its own log in. Want to see options for a different location? Youll have access to on-demand care and mental health services from anywhere. [Narrator] Our quality providers are here for you 24/7, 365. *Last Name. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. Access your health information, lab results and personalized tips from anywhere with your health dashboard. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). [Narrator] And you'll get support for more than just your physical health. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. When billing, you must use the most appropriate code as of the effective date of the submission. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. If you do not intend to leave our site, close this message. The AMA is a third party beneficiary to this Agreement. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Call your doctor with any questions or concerns about your health. The phone number that is part of this call campaign is: Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. This virtual care option is in addition to your traditional network of providers. [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? Have questions about our products, policies and services? Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Call a licensed agent at ${dynamicPhone} (TTY: 711),${hours}. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. 1-800-US-AETNA(1-800-872-3862) (TTY: 711)between 8:00 AM and 6:00 PM ET. Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), As we develop more health problems, our risk score increases. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Froma24-hour nurse line to vision and fitness, youre covered. Froma24-hour nurse line to vision and fitness, youre covered. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. I practice independently and I want to contract with Aetna. It is only a partial, general description of plan or program benefits and does not constitute a contract. Links to various non-Aetna sites are provided for your convenience only. CPT is a registered trademark of the American Medical Association. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Search for Medicare plans in your area here. Your benefits plan determines coverage. The Appointment of Representative form is on CMS.gov. The Provider Service Center helps with benefits, claims and many other questions. CPT is a registered trademark of the American Medical Association. Your InstaMed log in may be different from your Caremark.com secure member site log in. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". To view the form just select Continue. Sometimes you need a quick answer to a health question. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. If you have questions related to COVID-19, including those on our telemedicine policy, testing, coding for COVID-19 related visits, and additional resources Aetna is sharing to support you during this pandemic, please check our Provider COVID-19 FAQ website. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. Disclaimer of Warranties and Liabilities. Well, for starters it means you'll have more options for care. All Rights Reserved. We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, and more. Your Payer Express log-in may be different from your Aetna secure member site log-in. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. WebAetna Inc. 151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Skip to main content For CPT only copyright 2015 American Medical Association. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Contact a health care professional with any questions or concerns about specific health care needs.. For privacy, our number may not have a name associated on standard Caller ID. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. Members should discuss any matters related to their coverage or condition with their treating provider. (sneezes) Bless you. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. They do not have access Fields marked with an asterisk (*) are required. This site has its own login. You are now being directed to CVS Caremark site. If you do not intend to leave our site, close this message. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Staff on the nurse call line cannot diagnose, prescribe or give medical advice. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. We'll try our best to get back to you within 24 hours. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Your InstaMed log in may be different from your Caremark.com secure member site log in. Si tu intencin no era salir del sitio web, cierra este mensaje. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Treating providers are solely responsible for medical advice and treatment of members. Im turning 65 or just starting to explore Medicare. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Do you want to continue? Do you want to continue? You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. Want to see options for a different location? This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The ABA Medical Necessity Guidedoes not constitute medical advice. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna. Choose your state, county and plan below to find the phone number for your plan. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. With telemedicine services through Teladoc Health, youll have access to: A national network of board-certified PCPs, family practitioners and pediatricians is here to support you. The ABA Medical Necessity Guidedoes not constitute medical advice. The caller claims new cards from one of these agencies are in the works, and they need you to update your information on file. The Appointment of Representative form is on CMS.gov. The information you will be accessing is provided by another organization or vendor. Do you want to continue? Go to the American Medical Association Web site. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Torequest participation in First Health networks, follow the link below. WebUSA. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. And we've got you. Send us an email and well get back to you as soon as possible. Convenient and affordable care wherever you need it. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Others have four tiers, three tiers or two tiers. Get started with Teladoc Health through the Aetna HealthSMapp. Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Any information we provide is limited to those plans we do offer in your area. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Report the call. Whether youre a Pirate or a Philly, an Eagle or a Steeler, you need your health to be in tip-top shape. Just like that. If you have questions about Medicare, call 1-800-MEDICARE (633-4227). The AMA is a third party beneficiary to this Agreement. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. Information is believed to be accurate as of the production date; however, it is subject to change. Aetna handles premium payments through Payer Express, a trusted payment service. Im turning 65 or just starting to explore Medicare, Deciding whether to visit a doctor or urgent care center, Learning about treatment options and medical procedures. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. The information you will be accessing is provided by another organization or vendor. If you do not intend to leave our site, close this message. Treating providers are solely responsible for medical advice and treatment of members. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. CVS Health Virtual Care is all about you. This site has its own log in. Includes PPO, HMO, HMO-POS medical plans with or without drugs. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Call 1-855-835-2362to speak with a licensed Teladoc Health provider in minutes.*. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). But you never need to pay for a new card. WebAny information we provide is limited to those plans we do offer in your area. Please fill in all fields. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. Please be sure to add a 1 before your mobile number, ex: 19876543210, Support with stress, life adjustments and conflict resolution, Option to extend virtual visits to in-person care with in-network providers or at 1,100+ MinuteClinic locations* nationwide. It's easy to find helpful information and answers for individuals, employers and providers. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. So you feel better, sooner. The Appointment of Representative form is on CMS.gov. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare Aetna's conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna). Were available Monday through Friday, 9 AM to 6 PM ET. Call 1-800-556-1555 (TTY: 711) anytime. Consent is requested of both members and dependent children. You've probably heard of them but what does it really mean for you? Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). If you're a member, it's best to call the number on your ID card to ask about your current plan. Select a state below to update coverage details. Health benefits and health insurance plans contain exclusions and limitations. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Provider termination form and directory update. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). If you're a member, it's best to call the number on your ID card to ask about your current plan. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Please contact Medicare.gov or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 1-800-358 Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Your Payer Express log in may be different from your Aetna secure member site log in. Aetna Medicare is a HMO, PPO plan with a Medicare contract. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Applicable FARS/DFARS apply. In case of a conflict between your plan documents and this information, the plan documents will govern. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Unlisted, unspecified and nonspecific codes should be avoided. Call 1-800-MEDICARE (1-800-633-4227) or ${tty}: 1-877-486-2048, 7 days a week, 24 hours a day.If you need help in a language other than English or Spanish, say Agent to All Rights Reserved. The ABA Medical Necessity Guidedoes not constitute medical advice. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Plan features and availability may vary by service area. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Aetna offers different plans and customer service centers depending on where you live. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 1-866-235-5660${tty} The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. Having a partner to help you manage a chronic condition. Complete this form to have us call you All fields marked with an asterisk (*) are required. We received your request, and well get back to you shortly. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. For others, request to use the Aetna logo. 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number for the Corporate Contact Center. They do not have access to member accounts but they can provide Aetna Member Services contact information. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Write to us at Aetna Better Health of Ohio 7400 W. Campus Road New Albany, OH 43054 The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. I tell everyone who is having a To collect health assessment and lifestyle survey data. It is only a partial, general description of plan or program benefits and does not constitute a contract. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. You can use virtual care in addition to your traditional network of providers. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product.
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