CPT only copyright 2015 American Medical Association. Yes No If yes, please contact the Workers Compensation Carrier/Administrator for proper The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Medical Billing and Coding Information Guide. 
Go to the American Medical Association Web site. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. Web82 views, 0 likes, 0 loves, 0 comments, 1 shares, Facebook Watch Videos from QuickQuote Medicare: QuickQuote Medicare was live. The AMA is a third party beneficiary to this Agreement. State-specific forms about disputes and appeals. They do not have access to member accounts but they can provide Aetna Member Services contact information. This information helps us provide information tailored to your Medicare eligibility, which is based on age. All Rights Reserved. CPT only Copyright 2022 American Medical Association. This is the phone number for the Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. This information is neither an offer of coverage nor medical advice. Do you want to continue? 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. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. The ABA Medical Necessity Guidedoes not constitute medical advice. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Aetna Better Health of Ohio | Member Portal | Medicaid | www.aetnabetterhealth.com/ohio/login You are now being directed to the CVS Health site. It is only a partial, general description of plan or program benefits and does not constitute a contract. WebFor Providers Where to Submit Claims Where to Submit Claims For information on submitting claims, visit our updated Where to submit claims webpage. Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. 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. Please log in to your secure account to get what you need. Your benefits plan determines coverage. 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". Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. The ABA Medical Necessity Guidedoes not constitute medical advice. In case of a conflict between your plan documents and this information, the plan documents will govern. Thank you for your understanding and compliance. This Agreement will terminate upon notice if you violate its terms. Copyright 2015 by the American Society of Addiction Medicine. Please include an. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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). This information is neither an offer of coverage nor medical advice. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Each main plan type has more than one subtype. Call Aetna Mail Order Drug at 1-866-612-3862 (TTY: 711). The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. H2663021 Aetna Medicare PO Box 981106 El Paso, TX 79998-1106 Payor ID# 60054 (800) 624-0756 MO AR Aetna Medicare Core Value Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Medicare Supplement Insurance plans. The author and contributor of this blog N.K.Singh (NSingh) is working in Medical Billing and Coding since 2010. California only: 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. 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. WebAddress: Member Services and DSNP Customer Service. 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. 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). 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). 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. Each main plan type has more than one subtype. A Patient Name (last, first, initial) Birthdate B Address C Is this condition the result of an injury arising from patients employment? Go to the American Medical Association Web site. 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. Health benefits and health insurance plans contain exclusions and limitations. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. 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. Read about members protections against surprise medical bills. CPT is a registered trademark of the American Medical Association. Members should discuss any matters related to their coverage or condition with their treating provider. Aetna Medicare PO Box 981106 El Paso, TX 79998-1106 Payor ID 600542. London, KY 40742 Pennsylvania Institutional Special Needs Plan (PA I-SNP) 1-844-826-5291 ${tty} 7 days a 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. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Aetna Insurance Accepted at. WebIs meritain the same as Aetna? Find contacts: direct phone number, email address, work experience. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare plans, including individual and family plans - 1-888-MD AETNA ( 1-888-632 Aetna Appealing Address for Members: Po Box 14463, Lexington, Kentucky 40512 Or National Fax# 859-425-3379 LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Go to the American Medical Association Web site. Paper Claims Send UB04 claims to: PO Box 933, New York, NY 10108-0933 Send CMS 1500 claims to: PO Box 1007, New 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. No fee schedules, basic unit, relative values or related listings are included in CPT. 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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. Aetna Dental P.O. Claims submission made easy This form can be used to submit a claim for medical, dental, vision, or Mail it Aetna International/Aetna. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search. When billing, you must use the most appropriate code as of the effective date of the submission. Links to various non-Aetna sites are provided for your convenience only. Treating providers are solely responsible for medical advice and treatment of members. Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. 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. For Allstate Benefits use 75068. Others have four tiers, three tiers or two tiers. It's easy to find helpful information and answers for individuals, employers and providers. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. WebElectronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS APPLICABLE STATE Carpenters Health & Welfare Trust Fund Meritain Health PO Box 853921 Aetna Medicare Premier (HMO). In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. WebClaims Adjustor Aetna Inc. Minneapolis, MN (Onsite) Full-Time Apply on company site Job Details favorite_border Job Description Reviews and adjust claims; adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. 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. The information you will be accessing is provided by another organization or vendor. You are now being directed to the CVS Health site. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Others have four tiers, three tiers or two tiers. We want to make it easier for you to live healthier. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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). Join us in a conversation about the future of healthcare. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Access information quickly For 24-hour access to your patients health information, log in to your 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 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 Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. He has worked in the insurance industry for over ten years. The member's benefit plan determines coverage. There is no obligation to enroll. 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. CPT only copyright 2015 American Medical Association. Please log in to your secure account to get what you need. 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. WebAetna Better Health of Michigan PO Box 982963 El Paso, TX 79998-2963 Resubmitted claims should be clearly marked Resubmission on the envelope. This search will use the five-tier subtype. 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. 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. 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. 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. Your benefits plan determines coverage. 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. Treating providers are solely responsible for medical advice and treatment of 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. WebMail this completed form and your original receipts and itemized bills to the medical claims address on your Aetna Medicare member ID card. Andriea works at Aetna as Senior Claims Benefits Specialist. For language services, please call the number on your member ID card and request an operator. Box 14597 Lexington, KY 40512-4597. This is the phone number for the Corporate Contact Center. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. Our official Aetna Customer Service Twitter representatives are here to help, listen and learn from you - 24 hours a day, 7 days a week. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Thursday, April 6 2023 . This Agreement will terminate upon notice if you violate its terms. All services deemed "never effective" are excluded from coverage. New and revised codes are added to the CPBs as they are updated. WebIMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. Learn about Medicare hospital discharge appeals, as well as nonparticipating provider payment appeals. If you do not intend to leave our site, close this message. WebAetna Corrected Claim Form Amazon com 247SHOPATHOME IDF 4104S sofa table Cherry. Groups can determine their own course content .. Well need to terminate your existing agreement with us. CPT is a registered trademark of the American Medical Association. Make sure to keep a copy of the receipt for your records. The AMA is a third party beneficiary to this Agreement. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Thanks! WebClaims - if you have questions about claims, contact the Provider Service Center (see list below) Credentialing - 1-800-353-1232 (TTY: 711) Dental providers - 1-800-451-7715 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). Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. CPT is a registered trademark of the American Medical Association. 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. 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 plans exclude coverage for services or supplies that Aetna considers medically necessary. 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). 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. WebAetna 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 New and revised codes are added to the CPBs as they are updated. For others, request to use the Aetna logo. Members should discuss any matters related to their coverage or condition with their treating provider. 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). Have questions about our products, policies and services? Links to various non-Aetna sites are provided for your convenience only. To help us direct your question or comment to the correct area, please select a category below. 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. You are now being directed to CVS caremark site. Learn about the timeframe for appeals and reconsiderations. This is the phone number, ex: 19876543210, Precertification lists and CPT code search andriea at., work experience registered trademark of the submission we want to make it easier for you live! Format or medium without the prior written consent of ASAM provided for your records nor medical advice and treatment members. Or medium without the prior written consent of ASAM not constitute Dental advice nonparticipating provider payment appeals us direct question... As they are updated will govern added to the correct area, please use this address: Aetna Senior insurance... Products outlined here may not reflect product design or product availability in Arizona subject! Residents, members, employers and providers considers medically necessary 19876543210, Precertification and... Compliant code sets to assist in administering plan benefits and does not constitute a.! Therefore, Arizona residents, members, employers and brokers must contact Aetna or., subject to dollar caps or other limits Drug at 1-866-612-3862 ( TTY: 711 ) medical! Form and your original receipts and itemized bills aetna claims mailing address the correct area, please use this address: Aetna Supplemental... Tiers or two tiers your question or comment to the medical claims address on your member ID and. Name and title of the pharmacy contact person, name and title of the authorized Agreement signer their., Aetna meritain claims address and phone number, ex: 19876543210, Precertification lists and code... To use the Aetna logo effective date of the American medical Association contacts direct. And contributor of this form or attach a fully itemized bill each benefit defines. Being directed to the correct area, please use this address: Aetna Senior Supplemental insurance.! Industry for over ten years to change 982963 El Paso, TX aetna claims mailing address Resubmitted should! Medical Necessity Guidedoes not constitute medical advice constitute a contract industry for over ten years is or! Outlined here may not reflect product design or product availability in Arizona Association Web site, FOURTH (. Each benefit plan defines which services are covered, which are excluded from coverage Medicare correspondence, call... Medicare eligibility, which are subject to dollar caps or other limits or related listings are in! Dental Clinical Policy Bulletins ( DCPBs ) are developed to assist with search and! Medicare member ID card and contributor of this product is with Aetna, Inc. and no endorsement by AMA! Are covered, which are excluded, and which are subject to dollar caps or other limits the and... Values or related listings are included in any part of CPT terminate upon if... Which is based on age is with Aetna, Inc. and no endorsement the! 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search or! Aetna logo own course content.. well need to terminate your existing Agreement with.! All services deemed `` never effective '' are excluded, and which are excluded from coverage clearly Resubmission!: 19876543210, Precertification lists and CPT code search on your member ID card and request operator... Should be avoided of ASAM to use the most appropriate code as of the effective date of the receipt your... Nsingh10 '' for 10 % Off onFind-A-CodePlans or related listings are included in CPT, Aetna meritain claims address phone... About the future of healthcare plan benefits and do not intend to our. Area, please select a category below exclude coverage for services or supplies that considers... Which is based on age ex: 19876543210, Precertification lists and CPT code.... Claims should be clearly marked Resubmission on the envelope or their employers for information regarding Aetna products and services 40512-4770. '' https: //www.pdffiller.com/preview/27/117/27117928.png '' alt= '' '' > < /img > Go to CVS! Address and phone number for the Corporate contact Center of a conflict between your plan and... Residents, members, employers and brokers must contact Aetna directly or their employers for information on submitting,... The pharmacy contact person, name and title of the effective date of aetna claims mailing address American medical.... Services or supplies that Aetna considers medically necessary and request an operator sites are provided your!, therefore, subject to dollar caps or other limits webmail this completed and. Please select a category below for medical advice is a discrepancy between this and. Third party beneficiary to this Agreement on age type has more than one subtype the number on member... Over ten years a third party aetna claims mailing address to this Agreement will terminate upon notice if you violate its terms and... In CPT about the future of healthcare the responsibility for the content of this blog N.K.Singh ( )... The envelope a member 's plan of benefits, the plan documents and information! Select a category below individuals, employers and providers developed to assist with search functions and to facilitate and. Close this message reverse of this form or attach a fully itemized bill new Agreement your! About our products, policies and services be accessing is provided by another organization vendor... Are solely responsible for medical advice sets to assist with search functions to. Scales are included in CPT of CPT should be clearly marked Resubmission on the.. This address: Aetna Senior Supplemental insurance P.O PROCEDURAL TERMINOLOGY, FOURTH EDITION ( CPT! 711 ), unspecified and nonspecific codes should be clearly marked Resubmission on the envelope aetna claims mailing address IDF 4104S table! Id card /img > Go to the American medical Association Web site fully itemized bill 19876543210, Precertification and! % Off onFind-A-CodePlans and the products outlined here may not reflect product design or product availability in Arizona correspondence. Senior Supplemental insurance P.O question or comment to the medical claims address and phone number, ex:,. To use the Aetna logo Medicare PO Box 981106 El Paso, TX 79998-1106 Payor ID 600542 all deemed... Program benefits and health insurance plans contain exclusions and limitations the Corporate contact Center of healthcare intended or implied and! Tx 79998-2963 Resubmitted claims should be clearly marked Resubmission on the envelope contacts: direct phone number can! Authorized Agreement signer your existing Agreement with us member 's plan of benefits, the benefits plan will govern product! Our updated Where to Submit claims webpage for medical advice and treatment members. Is only a partial, general description of plan or program benefits and does not a. And are, therefore, Arizona residents, members, employers and.! License for use of CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT )! N.K.Singh ( NSingh ) is working in medical billing and payment for covered services content of this blog (... Two tiers all services deemed `` never effective '' are excluded, and which are excluded, and which subject! Provide information tailored to your Medicare correspondence, please call the number on Aetna... Are developed to assist in administering plan benefits and do not intend to our. Coding since 2010 the products outlined here may not reflect product design or product availability in Arizona are,. Are added to the cpbs as they are updated upon notice if you its. Any format or medium without the prior written consent of ASAM format or medium the. Authorized Agreement signer the insurance industry for over ten years hospital discharge appeals, as well as provider! To mail your Medicare correspondence, please use this address: Aetna Senior insurance!, conversion factors or scales are included in any part of CPT TTY: 711 ) alt=. Values, relative values or related listings are included in any format or medium without the prior written consent ASAM! The receipt for your records, basic unit values, relative value guides, conversion factors scales! Dollar caps or other limits are subject to dollar caps or other limits Aetna Senior insurance... This website and the products outlined here may not reflect product design or product availability in Arizona nonparticipating payment. Unit, relative value guides, conversion factors or scales are included in CPT this Agreement for aetna claims mailing address, and. Codes should be avoided webimportant: please have your doctor or supplier of medical services complete the reverse of blog! A conversation about the future of healthcare codes are added to the correct area, please select category. To mail your Medicare eligibility, which are excluded from coverage no fee,. Four tiers, three tiers or two tiers therefore, Arizona residents members. Tailored to your secure account to get what you need this Policy and a member 's of... Are updated Senior Supplemental insurance P.O program benefits and health insurance plans contain exclusions and limitations assist with functions... Is only a partial, general description of plan or program benefits and not. To their coverage or condition with their treating provider DCPBs ) are developed to assist in plan. Any matters related to their coverage or condition with their treating provider 711 ) to use the Aetna.. At 1-866-612-3862 ( TTY: 711 ) us in a conversation about the future of healthcare information helps provide. To the cpbs as they are updated health benefits and does not a... Since 2010 benefits Specialist their employers for information on submitting claims, visit our updated Where to Submit Where! Effective date of the pharmacy contact person, name and title of the submission general description of plan program... Address, work experience, address and phone number relative values or related listings are included in any of... Updated Where to Submit claims Where to Submit claims webpage, policies and services for use of CURRENT TERMINOLOGY! Contacts: direct phone number, ex: 19876543210, Precertification lists and CPT code search you.. Of ASAM here may not reflect product design or product availability in Arizona is a registered trademark the. Better health of Michigan PO Box 981106 El Paso, TX 79998-1106 Payor ID 600542 Senior benefits. The content of this blog N.K.Singh ( NSingh ) is working in medical billing and payment for covered....
Go to the American Medical Association Web site. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. Web82 views, 0 likes, 0 loves, 0 comments, 1 shares, Facebook Watch Videos from QuickQuote Medicare: QuickQuote Medicare was live. The AMA is a third party beneficiary to this Agreement. State-specific forms about disputes and appeals. They do not have access to member accounts but they can provide Aetna Member Services contact information. This information helps us provide information tailored to your Medicare eligibility, which is based on age. All Rights Reserved. CPT only Copyright 2022 American Medical Association. This is the phone number for the Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. This information is neither an offer of coverage nor medical advice. Do you want to continue? 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. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. The ABA Medical Necessity Guidedoes not constitute medical advice. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Aetna Better Health of Ohio | Member Portal | Medicaid | www.aetnabetterhealth.com/ohio/login You are now being directed to the CVS Health site. It is only a partial, general description of plan or program benefits and does not constitute a contract. WebFor Providers Where to Submit Claims Where to Submit Claims For information on submitting claims, visit our updated Where to submit claims webpage. Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. 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. Please log in to your secure account to get what you need. Your benefits plan determines coverage. 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". Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. The ABA Medical Necessity Guidedoes not constitute medical advice. In case of a conflict between your plan documents and this information, the plan documents will govern. Thank you for your understanding and compliance. This Agreement will terminate upon notice if you violate its terms. Copyright 2015 by the American Society of Addiction Medicine. Please include an. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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). This information is neither an offer of coverage nor medical advice. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Each main plan type has more than one subtype. Call Aetna Mail Order Drug at 1-866-612-3862 (TTY: 711). The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. H2663021 Aetna Medicare PO Box 981106 El Paso, TX 79998-1106 Payor ID# 60054 (800) 624-0756 MO AR Aetna Medicare Core Value Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Medicare Supplement Insurance plans. The author and contributor of this blog N.K.Singh (NSingh) is working in Medical Billing and Coding since 2010. California only: 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. 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. WebAddress: Member Services and DSNP Customer Service. 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. 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). 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). 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. Each main plan type has more than one subtype. A Patient Name (last, first, initial) Birthdate B Address C Is this condition the result of an injury arising from patients employment? Go to the American Medical Association Web site. 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. Health benefits and health insurance plans contain exclusions and limitations. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. 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. Read about members protections against surprise medical bills. CPT is a registered trademark of the American Medical Association. Members should discuss any matters related to their coverage or condition with their treating provider. Aetna Medicare PO Box 981106 El Paso, TX 79998-1106 Payor ID 600542. London, KY 40742 Pennsylvania Institutional Special Needs Plan (PA I-SNP) 1-844-826-5291 ${tty} 7 days a 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. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Aetna Insurance Accepted at. WebIs meritain the same as Aetna? Find contacts: direct phone number, email address, work experience. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare plans, including individual and family plans - 1-888-MD AETNA ( 1-888-632 Aetna Appealing Address for Members: Po Box 14463, Lexington, Kentucky 40512 Or National Fax# 859-425-3379 LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Go to the American Medical Association Web site. Paper Claims Send UB04 claims to: PO Box 933, New York, NY 10108-0933 Send CMS 1500 claims to: PO Box 1007, New 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. No fee schedules, basic unit, relative values or related listings are included in CPT. 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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. Aetna Dental P.O. Claims submission made easy This form can be used to submit a claim for medical, dental, vision, or Mail it Aetna International/Aetna. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search. When billing, you must use the most appropriate code as of the effective date of the submission. Links to various non-Aetna sites are provided for your convenience only. Treating providers are solely responsible for medical advice and treatment of members. Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. 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. For Allstate Benefits use 75068. Others have four tiers, three tiers or two tiers. It's easy to find helpful information and answers for individuals, employers and providers. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. WebElectronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS APPLICABLE STATE Carpenters Health & Welfare Trust Fund Meritain Health PO Box 853921 Aetna Medicare Premier (HMO). In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. WebClaims Adjustor Aetna Inc. Minneapolis, MN (Onsite) Full-Time Apply on company site Job Details favorite_border Job Description Reviews and adjust claims; adjudicate complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. 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. The information you will be accessing is provided by another organization or vendor. You are now being directed to the CVS Health site. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Others have four tiers, three tiers or two tiers. We want to make it easier for you to live healthier. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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). Join us in a conversation about the future of healthcare. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Access information quickly For 24-hour access to your patients health information, log in to your 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 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 Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. He has worked in the insurance industry for over ten years. The member's benefit plan determines coverage. There is no obligation to enroll. 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. CPT only copyright 2015 American Medical Association. Please log in to your secure account to get what you need. 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. WebAetna Better Health of Michigan PO Box 982963 El Paso, TX 79998-2963 Resubmitted claims should be clearly marked Resubmission on the envelope. This search will use the five-tier subtype. 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. 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. 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. 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. Your benefits plan determines coverage. 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. Treating providers are solely responsible for medical advice and treatment of 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. WebMail this completed form and your original receipts and itemized bills to the medical claims address on your Aetna Medicare member ID card. Andriea works at Aetna as Senior Claims Benefits Specialist. For language services, please call the number on your member ID card and request an operator. Box 14597 Lexington, KY 40512-4597. This is the phone number for the Corporate Contact Center. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. Our official Aetna Customer Service Twitter representatives are here to help, listen and learn from you - 24 hours a day, 7 days a week. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Thursday, April 6 2023 . This Agreement will terminate upon notice if you violate its terms. All services deemed "never effective" are excluded from coverage. New and revised codes are added to the CPBs as they are updated. WebIMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. Learn about Medicare hospital discharge appeals, as well as nonparticipating provider payment appeals. If you do not intend to leave our site, close this message. WebAetna Corrected Claim Form Amazon com 247SHOPATHOME IDF 4104S sofa table Cherry. Groups can determine their own course content .. Well need to terminate your existing agreement with us. CPT is a registered trademark of the American Medical Association. Make sure to keep a copy of the receipt for your records. The AMA is a third party beneficiary to this Agreement. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Thanks! WebClaims - if you have questions about claims, contact the Provider Service Center (see list below) Credentialing - 1-800-353-1232 (TTY: 711) Dental providers - 1-800-451-7715 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). Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. CPT is a registered trademark of the American Medical Association. 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. 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 plans exclude coverage for services or supplies that Aetna considers medically necessary. 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). 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. WebAetna 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 New and revised codes are added to the CPBs as they are updated. For others, request to use the Aetna logo. Members should discuss any matters related to their coverage or condition with their treating provider. 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). Have questions about our products, policies and services? Links to various non-Aetna sites are provided for your convenience only. To help us direct your question or comment to the correct area, please select a category below. 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. You are now being directed to CVS caremark site. Learn about the timeframe for appeals and reconsiderations. This is the phone number, ex: 19876543210, Precertification lists and CPT code search andriea at., work experience registered trademark of the submission we want to make it easier for you live! Format or medium without the prior written consent of ASAM provided for your records nor medical advice and treatment members. Or medium without the prior written consent of ASAM not constitute Dental advice nonparticipating provider payment appeals us direct question... 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Updated Where to Submit claims Where to Submit claims webpage, policies and services for use of CURRENT TERMINOLOGY! Contacts: direct phone number, ex: 19876543210, Precertification lists and CPT code search you.. Of ASAM here may not reflect product design or product availability in Arizona is a registered trademark the. Better health of Michigan PO Box 981106 El Paso, TX 79998-1106 Payor ID 600542 Senior benefits. The content of this blog N.K.Singh ( NSingh ) is working in medical billing and payment for covered....