1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. 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. Others have four tiers, three tiers or two tiers. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Aetna Inc. The ABA Medical Necessity Guidedoes not constitute medical advice. Submit your claims directly to Allied through the Emdeon-Change Healthcare clearinghouse and get paid faster. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. Each main plan type has more than one subtype. By clicking on I accept, I acknowledge and accept that: Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Andriea works at Aetna as Senior Claims Benefits Specialist. 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. Do you want to continue? Box 14094 Lexington, KY 40512-4094. The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. For current employers, health care professionals and producersget the Aetna logo. 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. 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. CPT is a registered trademark of the American Medical Association. All dental Medicare claims . 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. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. 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. Treating providers are solely responsible for medical advice and treatment of members. This search will use the five-tier subtype. 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). The AMA is a third party beneficiary to this Agreement. I may or may not be employed by an Aetna-contracted provider. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Applicable FARS/DFARS apply. Web151 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. 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. Fidelis Care will continue to make these investments as part of our commitment to improving interfaces with our providers. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. I practice independently and I want to contract with Aetna. It's easy to update a provider address, phone number, fax number, email address or initiate an out-of-state move or a change in provider group. We also have a list of state exceptions to our 180-day filing standard. Aetna Claims Address. Hartford, CT 06156 Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. This search will use the five-tier subtype. Aetna claims phone number: For Medical coverage decision Mailing Address: Medical Service: PO Box 14079 Lexington, CPT only copyright 2015 American Medical Association. Medicare Advantage and Prescription Drug Plans. CPT is a registered trademark of the American Medical Association. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Go to the American Medical Association Web site.
In case of a conflict between your plan documents and this information, the plan documents will govern. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Take charge of your vision and overall health as an Aetna member! Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. For language services, please call the number on your member ID card and request an operator. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies (Aetna). The member's benefit plan determines coverage.

MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. The content shared in this website is for education and training purpose only. Have questions about our products, policies and services? Thanks! 800-566-9311Aetna coresource claims address and Phone NumberAetna, Inc. P O Box 981107El Paso, TX 79998-1107800-793-8616Aetna credentialing phone number800-353-1232, Aetna claim address and Aetna phone numbers are very important to handling denials, AR follow-up and claim submission. If you do not intend to leave our site, close this message. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Disclaimer of Warranties and Liabilities. In Singapore, Michael specializes in Employee Benefits Insurance, WICA insurance, Group Insurance and Business insurance. Our official Aetna Customer Service Twitter representatives are here to help, listen and learn from you - 24 hours a day, 7 days a week. Webwww.aetnainternational.com and clicking 'Contact us'. 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. You may opt out at any time. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Your peripheral vision is reduced and whilst you may not se.. We are classified as a Close Proximity Business under the Covid-19 Protection Framework (Traffic Lights). CPT is registered trademark of American Medical Association. 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). 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 five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. 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. In my opinion FSBP is the best for overseas members. 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. CPT only copyright 2015 American Medical Association. Unlisted, unspecified and nonspecific codes should be avoided. Access information quickly For 24-hour access to your patients health information, log in to your WebAetna Better Health of Michigan PO Box 982963 El Paso, TX 79998-2963 Resubmitted claims should be clearly marked Resubmission on the envelope. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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.

Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Email, call or chat with 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). Breaking News. 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. file or submit a claim aetna medicaid florida web claim adjustment request claim reconsideration form pdf an updated copy of the claim all lines must be rebilled a copy of the original claim reprint or copy is acceptable a copy of the remittance It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. WebSubmitting claims for Aetna Signature Administrators plan. CPT only Copyright 2022 American Medical Association. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. This search will use the five-tier subtype. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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 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. What is the procedure for disputing a claim decision? 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. 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. Clinical Policy code search clearinghouse and get paid faster responsible for Medical advice Policy Bulletins ( CPBs are. Am to 8 PM type has more than one subtype my opinion is... Your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O their employers for information regarding products... Youd like to mail your Medicare correspondence, please call the number on your member card!, WICA Insurance, Group Insurance and Business Insurance and the products outlined here not! One subtype charge of your vision and overall health as an Aetna member 8 AM to 8 PM govern! 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