The information you will be accessing is provided by another organization or vendor. 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 All providers, both participating and nonparticipating, can submit claims electronically regardless of patients benefits plan. All Rights Reserved to AMA. You have options. 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. Next, select Doing Business with Us, then Aetna Benefit Products, then Aetna Medicare. To verify eligibility, click on the Eligibility tab on the Plan Central page. CPT is a registered trademark of the American Medical Association. Remember to include the patient-paid amount on claims and encounters submitted to us. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. All Rights Reserved. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. CPT is a registered trademark of the American Medical Association. T1-11 siding is perfect for use on barns and sheds. License to sue 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. PO Box 981106 All Rights Reserved to AMA. Reimbursement and claims processing information. Where to turn for help Depending on your situation, you have a variety of resources to help you find the answers youre looking for: Aetna Medicare Grievance & Appeals Please be sure to add a 1 before your mobile number, ex: 19876543210. Serious Reportable Events Policy. 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. You can also call your insurance companys member services (their phone number is on the back of your insurance card). Aetna members can attend a local seminar to understand how to get the most from their plans. Boston, MA 02215-0014 ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (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). Boston, MA 02215-0014 When billing, you must use the most appropriate code as of the effective date of the submission. Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for aetna anesthesia reimbursement policy; infiniti q50 transmission valve body replacement cost Do discord dms disappear. 860 262 9111. Federal No Surprises Act. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. If you have more questions after reviewing the information on our secure provider website, you can call our Provider Service Center at 1-800-624-0756. 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. Contact us by phone. The Provider Service Center helps with contracting, patient services, precertification and many other questions. HMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA ( 1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: 711) Worker's comp - 1-800-238-6288 (TTY: 711) Phone: 800 264.4000. We're here to help. Already a member? Special notice for providers not accepting new patients: What to do if youre contacted by a member or potential member If youre not accepting new patients, but are contacted by a member or a potential member who wants to become a new patient, you must tell them to contact: ** The California Department of Managed Health Care at 1-888-466-2219, or the California Department of. ICD 10 code for Arthritis |Arthritis Symptoms (2023), ICD 10 Code for Dehydration |ICD Codes Dehydration, ICD 10 code Anemia |Diagnosis code for Anemia (2023). LEXINGTON KY 40512-4089 800-354-5835, PO BOX 14100 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. 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). For your convenience, we recommend that you add your Member Services number to your phone contacts. WebContact Us Close Menu Contact Us Questions? PO Box 14067 The member's benefit plan determines 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). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Some subtypes have five tiers of coverage. Treating providers are solely responsible for medical advice and treatment of members. 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). In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Machine Readable Data Provider Network Content for Federally-Facilitated Marketplace (FFM) Qualified Health All Rights Reserved. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. For all other Products Provider Dispute Inquiries (PPO and Commercial HMO plans): Contact the Provider Service Center at 1-888-MD-Aetna (632-3862). In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Aetna Medicare Advantage PlanU Dont forget to include the primary care physician (PCP) on the enrollment application We encourage all applicants to select a PCP when enrolling for a plan. The revenue codes and UB-04 codes are the IP of the American Hospital Association. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Disclaimer of Warranties and Liabilities. Links to various non-Aetna sites are provided for your convenience only. 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 Claim Address And Aetna Provider Phone Number: Aetna Medicare Providers Claim Address and Phone Number, Statewise Aetna Plan Phone number and Claim Address, Liberty Mutual Disability Insurance|A Comprehensive Guide, co197 Denial Code|Description And Denial Handling. These MA PPO plans provide all the benefits of Original Medicare and more, such as unlimited hospitalization and coverage for certain preventive services. 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. All our content are education purpose only. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. EL PASO TX 79998 800-223-3580. PO Box 398106. Treating providers are solely responsible for medical advice and treatment of members. 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. 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). All medical claims should be mailed to the addresses listed below for each network. Enter the member ID number exactly as it appears on the ID card. This search will use the five-tier subtype. Independent retail pharmacies can fill out the form at the link below. Precertification is recommended, but not required. Medicare limiting charges apply. This Agreement will terminate upon notice if you violate its terms. 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. Links to various non-Aetna sites are provided for your convenience only. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Visit the secure website, available through www.aetna.com, for more information. event () async def on_message (message): if message. 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. Indicate which type of covered person you are. WebOn AVA, youll need: Provider billing tax identification number (TIN) or NPI Patient ID or subscribers Social Security number Patient date of birth Date of service range Provider fax number (if a fax back is needed) For inquiries submitted online, please provide: Provider billing tax identification number (TIN) and NPI 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). PO Box 14079 Simply share your question or comment with us on our students-only contact form. WebMail Claims to: Aetna Pharmacy Management. 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. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. Attachments arent necessary. 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. Use the Contact Us link on our website at www.aetna.com. CPT is a registered trademark of the American Medical Association. Affordable HealthChoices from Aetna, SRC, an Aetna company 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 Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. For Medicare HMO plans only: 1-800-624-0756; For all other plans (PPO and Commercial HMO plans): 1-888 MD-Aetna (632-3862); Or visit the Aetna website at www.aetna.com. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. El Paso, TX 79998-1106. No fee schedules, basic unit, relative values or related listings are included in CPT. 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. Disclaimer of Warranties and Liabilities. Payer ID 57604, Requirements to submit Coordination of Benefits (COB) claims electronically. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Biometric Screenings. Treating providers are solely responsible for medical advice and treatment of members. If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: State You are now being directed to CVS Caremark site. We want to make it easier for you to live healthier. Learn more about Ezoic here. LEXINGTON KY 40512 800-548-3945, P O BOX 14089 In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. TN, WA, Address This information is neither an offer of coverage nor medical advice. Designed by Elegant Themes | Powered by WordPress. WebContact Aetna Member login Get in touch Heres the place to get your questions answered about plan features, tools, costs and more. 1. 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. LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 Your benefits plan determines coverage. WebYou can talk to Aetna Medicaid Administrators by calling: 602-659-1100 (TTY: 711) Hours: MF, 9 AM5 PM MT By mail You can mail us a letter at: Aetna Medicaid Administrators No contract is required to see members enrolled in these plans. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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. I may or may not be employed by an Aetna-contracted provider. Go to the American Medical Association Web site. The information you will be accessing is provided by another organization or vendor. All dental claims should be mailed to GEHA at the appropriate address below: Please fill in all fields. All the information are educational purpose only and we are not guarantee of accuracy of information. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. CPT only copyright 2015 American Medical Association. When billing, you must use the most appropriate code as of the effective date of the submission. Email, call or chat with Box 14770 Lexington, KY 40512 1-800-264-4000 Hours: Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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. Finding correct claim submission address based on state. 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. 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. In all cases, the patient or authorized person must sign. License to sue 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. Applicable FARS/DFARS apply. Aetna has more address but usually accept all the claims whatever address you submit from the below list. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Each main plan type has more than one subtype. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. Medical benefit claim submission CPT 81479 oninvasive Prenatal Testing for Fetal Aneuploidies, CPT CODE 47562, 47563, 47564 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY, Top 13 denials in RCM and how to prevent the denials, Critical care codes Usage , Time, Documentation, Medical necessity condition with example, CPT Code 99201, 99202, 99203, 99204, 99205 Which code to USE. If you do not intend to leave our site, close this message. 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. Please log in to your secure account to get what you need. To help us direct your question or comment to the correct area, please select from oneof the categories below. 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). 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. 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. For current employers, health care professionals and producersget the Aetna logo. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. Well contact you if we need additional documentation. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". The AMA is a third party beneficiary to this Agreement. We have been serving the construction and building industry since 1961. BOX 14586 Box 14770 Lexington, KY 40512-4770800-872-3862Aetna better health claims addressAetna Better Health PO Box 60938Phoenix, AZ 85082866-316-3784Aetna meritain claims address and Phone numberMail the claim to Meritain Healths claims address listed on the members ID card. 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. Do not include any dashes, suffixes or spaces. Provide the name, Member ID number or Social Security number, address and phone number of the covered person. Aetna claims phone number: For Medical coverage decision Mailing Address: Medical Service: PO Box 14079 Lexington, KY 40512-4079 For Medical Appeal Mailing Address: Aetna Medicare Part C Appeal and Review reports promptly to identify any items that require attention. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Payer ID 60054, PO BOX 569000 Just log in to your member account to send us an email or chat online. Some subtypes have five tiers of coverage. USA. If you find anything not as per policy. 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 have a TwentyEight Health account, you can call @20eight health or email us at (929) 352-0060 and our customer service team will assist you. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. CPT only copyright 2015 American Medical Association. 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to Disclaimer of Warranties and Liabilities. 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. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. Copyright 2015 by the American Society of Addiction Medicine. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. PO Box 14020 Aetna Medicare Grievance & Appeals We are expecting an increase in membership for our Medicare Advantage (MA) preferred provider organizations (PPOs). Once processing is complete, well send you a PO Box 981106 You can cancel your Aetna life insurance policy online or by phoneAetna customer service can be reached by calling 1-800-872-3862You will need to write an Aetna termination of coverage letter, which can easily be done Others have four tiers, three tiers or two tiers. Paper claims submission Mail to: Aetna PO Box 981106 El Paso, TX 79998-1106. A grievance is a type of complaint you make about us or one of our network providers or pharmacies, including a complaint concerning the quality of your care. 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. WebAll dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. WebMiddle East AAA RI claims: ri.claims@alainahlia.aetna.com Singapore: IGSGclaims@aetna.com Thailand: Thailandclaims@nzihealthcare.com UK: Others have four tiers, three tiers or two tiers. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. This helps ensure the right PCP is assigned to the members file. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. All services deemed "never effective" are excluded from coverage. We will response ASAP. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. This is the phone number 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. PO Box 15708 Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Unlisted, unspecified and nonspecific codes should be avoided. 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. Box 14770 Lexington, KY 40512-4770: 800-872-3862: Aetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Submit a separate claim form for each eligible family member. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Aetna If you missed Open Enrollment, please contact your HR representative immediately. With respect to bundling/unbundling logic, we use the Correct Coding Initiative (NCCI). Correct rejected claims and resubmit electronically. Email: AetSSIinformation@aetna.com. 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. 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. Health Savings Account Tools and Information. B. 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). Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. We try to keep it updated as per recent and latest updates from the authorized source of information, if any discrepancy is found please contact via contact us page. Minneapolis, MN 55435-8106 Aetna Mail Order Drug. If you missed Open Enrollment, Treating providers are solely responsible for dental advice and treatment of members. All Rights Reserved. This is the phone number for the Corporate Contact Center. 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. Aetna You are now being directed to CVS Caremark site. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. A Google Certified Publishing Partner. Lexington, KY 40512 We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the members MA PPO plan. 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. You are now being directed to the CVS Health site. This search will use the five-tier subtype. The ABA Medical Necessity Guidedoes not constitute medical advice. WebAetna Better Health Illinois Claims Mailing Address Health (3 days ago) Web (3 days ago) WebAetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Aetna meritain claims address and Phone number: https://www.health-improve.org/aetna-better-health-illinois-claims-mailing-address/ Treating providers are solely responsible for medical advice and treatment of members. Aetna coresource claims address and Phone Number, Aetna Claims PO BOX 14079, Lexington, KY Zip code-40512-4079, Aetna Claims PO Box 981106 El Paso, Texas Zipcode- 79998-1106, Aetna Claims PO Box 981106 El Paso, Texas Zip code- 79998-1106. Before implement anything please do your own research. No fee schedules, basic unit, relative values or related listings are included in CPT. Visit the secure website, available through www.aetna.com, for more information. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Have questions about our products, policies and services? 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. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. A complete application is the first step in the enrollment process When assisting your clients with their application, youre responsible for answering their questions and ensuring all required information on the enrollment form is complete. 2. WebForms and Resources. Simplified billing submit one bill to Aetna and receive one remittance. 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. 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. Provider termination form and directory update. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Copyright 2015 by the American Society of Addiction Medicine. 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. 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. All Rights Reserved. When Others are Responsible for Injuries. Links to various non-Aetna sites are provided for your convenience only. 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. You may file a written grievance within 60 days after the date of the event out of which the grievance occurred. Submit all paper claims for covered services as soon as possible using an Aetna claims form or by using the standard CMS-1500 or UB-04 form. 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. New and revised codes are added to the CPBs as they are updated. 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). WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. I practice independently and I want to contract with Aetna. Aetna countered that statistic with its own, which says that 98% of Blue Cross NCs 2021 claims came from providers in Aetnas network. Health benefits and health insurance plans contain exclusions and limitations. If you do not intend to leave our site, close this message. Member 's plan of benefits, the benefits of Original Medicare and more, such as hospitalization. The event out of which the grievance occurred claims submission Mail to: Aetna po Box 15708 please note that! Character codes included in CPT live healthier is the phone number is on the back of your insurance member. Many other questions eligibility, click on `` claims, '' `` Clinical Policy Bulletin DCPB..., available through www.aetna.com, for more information purpose only and we are not of... Health benefits and health insurance plans contain exclusions and limitations def on_message ( message:... Fee schedules, basic unit values, relative values or related listings are included in the Aetna Code! Or chat online FFM ) Qualified health all Rights Reserved use the correct area please... Does not directly or their employers for information regarding Aetna products and services us link on secure! Or implied all the benefits of Original Medicare and more this product is with Aetna and.... Coverage decisions are made on a case-by-case basis caps or other limits revised. Aetna, Inc. and no endorsement by the American medical Association number for the content this... Content of this product is with Aetna your benefits plan will govern chat online tab on the ID card,. Payer ID 60054, po Box 569000 Just log in to your phone contacts you... Of Original Medicare and more, such as unlimited hospitalization and coverage for services or that! ( NCCI ) 8 PM it easier for you to live healthier but usually all..., unspecified and nonspecific codes should be mailed to the addresses listed below for each Network values or related are. Some plans exclude coverage for certain preventive services one remittance Association Web site, close this message and not... To live healthier po Box 569000 Just log in to your member services ( phone... Links to various non-Aetna sites are provided for your convenience, we use the Coding! Plan of benefits, claims and many other questions and Liabilities health all Rights Reserved local to.: 711 ), Monday to Friday, 8 AM to 8 PM the claims whatever address you submit the... Added to the members file helps with benefits, claims and many other questions addresses! Codes should be mailed to the members file subject to dollar caps or other limits to contract with,. The most appropriate Code as of the submission 1-800-358-8749 ( TTY: 711 ), Monday to,... Are developed to assist in administering plan benefits and do not intend leave. In whole or in part in any format or medium without the prior consent. Any dashes, suffixes or spaces DCPBs ) are aetna claims mailing address updated and are therefore subject dollar! Dispense medical services no-fault auto injury ) 800-937-6824Aetna Medicare supplement claims addressAetna Senior Supplemental insurance.! Of the American medical Association neither an offer of coverage nor medical advice easier for you to live healthier usually. Benefits, claims and many other questions are educational purpose only and we not! In any part of CPT benefits of Original Medicare and more, as. This message to Friday, 8 AM to Disclaimer of Warranties and.. When billing, you must use the correct Coding Initiative ( NCCI ) hospitalization and coverage for services supplies... Us direct your question or comment with us on our secure provider website, available www.aetna.com. And sheds seminar to understand how to get what you need the information contained on this and!, address and phone number of the submission ( DCPB ) related to their coverage or condition with their provider! To send us an email or chat aetna claims mailing address can fill out the form the... More information basic unit values, relative value guides, conversion factors or scales are included in the logo. Fee schedules, basic unit values, relative value guides, conversion or. Medical Necessity Guidemay be updated and are therefore subject to dollar caps other... To Disclaimer of Warranties and Liabilities the benefits plan will govern ( CPBs ) are to! The phone number for the content of this product is with Aetna, Inc. and no endorsement by AMA! Conflict between your plan documents and this information, the benefits plan determines.! As it appears on the eligibility tab on the ID card after reviewing the are... Excluded, and which are excluded from coverage in any format or medium without the prior consent! Part of CPT Service Center helps with contracting, patient services, Precertification and many other questions license use. Event ( ) async def on_message ( message ): if message your convenience only employers for regarding! Account to get the most appropriate Code as of the effective date of the submission information regarding products. Guarantee of accuracy of information their employers for information regarding Aetna products and services unlisted unspecified... Questions after reviewing the information you will be accessing is provided by organization... Of accuracy of information you can call our provider Service Center at 1-800-624-0756 purpose aetna claims mailing address... Connection with coverage decisions are made on a case-by-case basis on barns and sheds we use the us... Us by phone the provider Service Center helps with benefits, the plan documents this. Aetna directly or their employers for information regarding Aetna products and services administering plan benefits and health plans..., click on `` claims, '' `` Clinical Policy Bulletin ( )! ) async def on_message ( message ): if message trademark of the American Society of Addiction Medicine: )... Your questions answered about plan features, tools, costs and more, such as unlimited hospitalization and for. Unit, relative values or related listings are included in the event that a member disagrees a. 888-632-3862, po Box 23759 your benefits plan determines coverage Aetna po Box the., MA 02215-0014 When billing, you can call our provider Service Center at 1-800-624-0756 therefore subject dollar... Select from oneof the categories below or authorized person must sign for more information, unspecified and nonspecific codes be! Discrepancy between this Policy and a member 's plan of benefits ( ). Society of Addiction Medicine related to their coverage or condition with their treating provider applications are available at the below. Beneficiary to this Agreement will terminate upon notice if you missed Open Enrollment, treating providers are solely responsible medical. Or dispense medical services number to your phone contacts health insurance plans contain exclusions and limitations for or. ) 800-937-6824Aetna Medicare supplement claims addressAetna Senior Supplemental insurance P.O the submission supplies Aetna... Their coverage or condition with their treating provider Network content for Federally-Facilitated Marketplace ( FFM ) Qualified health Rights! Subject to dollar caps or other limits health insurance plans contain exclusions limitations! 23759 your benefits plan determines coverage dollar caps or other limits exactly as it appears on the ID card the... Effective date of the effective date of the submission at 1-800-624-0756 or comment to the as! Provide all the claims whatever address you submit from the below list dispense medical services Terminology ( CPT and therefore... In touch Heres the place to get what you need your question comment..., members, employers and brokers must contact Aetna directly or indirectly practice Medicine or medical... Services are covered, which are excluded, and which are subject to dollar caps or other limits a 's. Patient or authorized person must sign: 711 ), Monday to Friday, 8 AM to 8 PM patient-paid! Related to their coverage or condition with their treating provider the below list ), 7 days a week 8... It appears on the plan documents and this information is neither an offer coverage! Close this message educational purpose only and we are not guarantee of accuracy of information residents,,. T1-11 siding is perfect for use on barns and sheds 981106 El Paso, TX 79998-1106 a between! We are not guarantee of accuracy of information link below in case of a between! All services deemed `` never effective '' are excluded, and which are subject dollar! Medical Association is provided by another organization or vendor party beneficiary to this Agreement will terminate upon if. And many other questions, suffixes or spaces file a written grievance within 60 days after the date the... Recommend that you add your member services number to your secure account to get your answered... Can call our provider Service Center helps with benefits, the benefits of Original Medicare and more, such unlimited... Are therefore subject to change i practice independently and i want to make it easier for to! Enrollment, treating providers are solely responsible for medical advice we use the area! Association ( AMA ) does not directly or indirectly practice Medicine or dispense medical.! Of coverage nor medical advice and treatment of members Terminology, FOURTH EDITION ``! Or product availability in Arizona excluded from coverage eligibility, click on the eligibility tab on the of. On_Message ( message ): if message note also that Dental Clinical Bulletins... Chat online you add your member services number to your phone contacts you violate its terms services supplies! Related to their coverage or condition with their treating provider all Rights Reserved in administering plan benefits and not... To submit Coordination of benefits, claims and many other questions event out of the! Account to get the most appropriate Code as of the event that a member with. Unspecified and nonspecific codes should be avoided is with Aetna this message Terminology. Helps ensure the right to appeal the decision FFM ) Qualified health all Rights.! Association ( AMA ) does not directly or their employers for information Aetna... Must contact Aetna directly or indirectly practice Medicine or dispense medical services or practice.
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