If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. The member's benefit plan determines coverage. Aetna Signature Administrators800-238-6288CoverMyMeds866-452-5017Coventry (workers comp and no-fault auto injury)800-937-6824Aetna medicare supplement claims addressAetna Senior Supplemental Insurance P.O. Treating providers are solely responsible for medical advice and treatment of members. For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies. Address Well need to terminate your existing agreement with us. 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. When billing, you must use the most appropriate code as of the effective date of the submission. P.O. Your benefits plan determines coverage. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Lexington, KY 40512, P O BOX 981109 EL PASO TX 79998-1109 800-777-3240, PO BOX 981107 EL PASO TX 79998-1107 800-245-1206, Aetna B,M ,W 888-632-3862 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). CPT only Copyright 2022 American Medical Association. This search will use the five-tier subtype. Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. For language services, please call the number on your member ID card and request an operator. The information you will be accessing is provided by another organization or vendor. When billing, you must use the most appropriate code as of the effective date of the submission. Dont have an account? Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Each main plan type has more than one subtype. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. PO Box 14079 You are now being directed to CVS Caremark site. CPT is a registered trademark of the American Medical Association. For out-of-network We have been serving the construction and building industry since 1961. Each main plan type has more than one subtype. Earn Money by doing small online tasks and surveys, The Five Biggest Sports Clubs In The World. Others have four tiers, three tiers or two tiers. If necessary, use the following claims billing addresses If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: This statement contains information regarding certain notice requirements, Claim Settlement procedures, the Provider Dispute Resolution process, and Aetna Payment Policies. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. All services deemed "never effective" are excluded from coverage. 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). ICD 10 Code for Obesity| What is Obesity ? If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. Aetna WebContact Us Close Menu Contact Us Questions? All Rights Reserved. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. CPT only copyright 2015 American Medical Association. Go to the American Medical Association Web site. Be sure to have your student ID number. 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. B. El Paso, TX 79998-1106, Appeals Mailing Address Provider Resolution Team LA, MS, NC, NM, NV, OR, SC, UT, Aetna Better Health of Kentuckys standard contacts are listed below: Aetna Better Health contacts Toll-free Fax Provider Services CICR (Claims Inquiry and claims research) 1-855-300-5528, Behavioral Health 1-888-604-6106 1-855-301-1564, Retrospective Review 1-888-470-0550, #4, #3, #7 1-855-336-6054, Concurrent Review 1-888-470-0550, #4, #3, #6 1-855-454-5043, Prior Authorization Medical 1-888-725-4969 1-855-454-5579, Prior Authorization Behavioral Health 1-888-604-6106 1-855-301-1564, Prior Authorization Pharmacy 1-855-300-5528 1-855-799-2550, Provider Relations 1-855-454-0061 1-855-454-5584, Care/Disease Management 1-888-470-0550 1-855-454-5044, Lock-In Program 1-855-300-5528 1-866-415-2818. Aetna Medicare Grivance submission address. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Claims Inquiries To confirm the recorded date of claims receipt or to make other inquiries about claims, you may call Aetna at 1-800-624-0756 for Medicare HMO Products / 1-888-MD-Aetna (632-3862) for All Other Products, or contact your clearinghouse vendor. 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. What is Medical Billing and Medical Billing process steps in USA? Health benefits and health insurance plans contain exclusions and limitations. Before implement anything please do your own research. All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. Members should discuss any matters related to their coverage or condition with their treating provider. 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. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. Go to the American Medical Association Web site. 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. 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. T1-11 siding is perfect for use on barns and sheds. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Independent retail pharmacies can fill out the form at the link below. CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY, Address WebAetna Claim AddressAetna Provider Phone Number Updated (2023) Health (3 days ago) WebAetna medicare supplement claims address: Aetna Senior Supplemental Insurance P.O. In case of a conflict between your plan documents and this information, the plan documents will govern. Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Please be sure to add a 1 before your mobile number, ex: 19876543210. D. Your signature is required to complete this form. Lexington, KY 40512-4079 AETNA Treating providers are solely responsible for dental advice and treatment of members. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. 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. If you find anything not as per policy. Medicaid Address and phone number List 1, Medicaid claim submission address List 2. While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. 860 262 9111. 79998-1106, Aetna Student HealthSM For questions on how to submit electronic claims to third-party administrators, such as an individual practice association, contact the third-party administrator. The ABA Medical Necessity Guidedoes not constitute medical advice. 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). If you do not intend to leave our site, close this message. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The member's benefit plan determines coverage.
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