Want to see options for a different location? In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Skip to main content For Do you want to continue? Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. I practice independently and I want to contract with 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. This search will use the five-tier subtype. 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. If you do not intend to leave our site, close this message. The member's benefit plan determines coverage. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. To view the form just select Continue. Applicable FARS/DFARS apply. If youre an Aetna member, you can call us for help. Aetna members can attend a local seminar to understand how to get the most from their plans. Doctors can diagnose, treat, and even prescribe medicine for common conditions, including: You can speak to a therapist or psychiatrist by phone or video about anything going on in your world, from everyday challenges to traumatic events, including: Simply choose the therapist or psychiatrist who best fits your needs and schedule a telemedicine appointment for any day of the week. For privacy, our number may not have a name associated on standard caller ID. Links to various non-Aetna sites are provided for your convenience only. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies. 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. 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. To view the form just select Continue. Call a licensed agent at ${dynamicPhone} (TTY: 711),${hours}. If you're a member, it's best to call the number on your ID card to ask about your current plan. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. New and revised codes are added to the CPBs as they are updated. Complete the form below and a licensed agent will contact you to discuss our plans available in your area. Virtual appointments available seven days a week. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. The home visits conducted by Medicare Advantage plans allow for the capture of more diagnoses, which in turn increases the risk score that adjusts plan payments from Medicare. Dual Eligible Special Needs Plans (D-SNP). The Appointment of Representative form is on CMS.gov. Visit the secure website, available through www.aetna.com, for more information. This virtual care option is in addition to your traditional network of providers. 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). Each main plan type has more than one subtype. Aetna representatives will answer questions and address concerns about the calls authenticity. Were bringing you to our trusted partner to help process your payments. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. CPT is a registered trademark of the American Medical Association. Others have four tiers, three tiers or two tiers. With 24/7 on-demand care, youll never have to. WebContact Aetna Get the answers you need here 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. 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. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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. 1-800-US-AETNA(1-800-872-3862) (TTY: 711)between 8:00 AM and 6:00 PM ET. 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 member's benefit plan determines coverage. 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. Yes, I'm a memberNo, I'm looking for a plan. Or simply go to our Get Started page. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Let us help! 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. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Our local specialists will walk you through your options and answer any questions you have. WebAetna Medicare Insurance for Pennsylvanians. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Links to various non-Aetna sites are provided for your convenience only. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Were bringing you to our trusted partner to help process your payments. Condition support to help you get and stay well. For a complete description of the limitations of Teladoc services, visit Teladoc. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Then, have your visit within 72 hours from wherever you are. But you never need to pay for a new card. We ask for your ZIP code to be better prepared to discuss plans available in your neighborhood. This is the phone number for the Corporate Contact Center. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. *First Name. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. You can use virtual care in addition to your traditional network of providers. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. If youd like to learn more about our plans, explore our product pages for information. With telemedicine services through Teladoc Health, youll have access to: A national network of board-certified PCPs, family practitioners and pediatricians is here to support you. So if you cant make an in-person visit or want to avoid the ER, you have convenient support to take care of you. Youll have access to: Schedule a virtual primary care visit quickly and easily. CPT only copyright 2015 American Medical Association. Visit the secure website, available through www.aetna.com, for more information. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. I may or may not be employed by an Aetna-contracted provider. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. We know insurance is confusing and you have questions. Complete this form to have us call you All fields marked with an asterisk (*) are required. If you need urgent or emergency care, call 911 and/or your doctor immediately. 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. So if you cant make an in Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Go to the American Medical Association Web site. 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. This search will use the five-tier subtype. [Virtual care professional] It's my pleasure. Teladoc Health and the Teladoc Health logo are registered trademarks or trademarks of Teladoc Health, Inc. Health benefits and health insurance plans contain exclusions and limitations. You can also call Aetna Member Services by calling the phone number on the back of your ID card. CPT only Copyright 2022 American Medical Association. For others, request to use the Aetna logo. 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number for the Corporate Contact Center. They do not have access to member accounts but they can provide Aetna Member Services contact information. Have questions about our products, policies and services? 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. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Disclaimer of Warranties and Liabilities. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. Call us. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. All Rights Reserved. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. You are leaving our Medicare website and going to our non-Medicare website. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 The information you will be accessing is provided by another organization or vendor. All fields marked with an asterisk (*) are required. CPT is a registered trademark of the American Medical Association. If you have questions, reach out to your HR benefits manager. For language services, please call the number on your member ID card and request an operator. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Treating providers are solely responsible for medical advice and treatment of members. We received your request, and well get back to you shortly. Members should discuss any matters related to their coverage or condition with their treating provider. 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. 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. 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). Treating providers are solely responsible for medical advice and treatment of members. 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. 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). Fields marked with an asterisk (*) are required. Your benefits plan determines coverage. Health benefits and health insurance plans contain exclusions and limitations. Independent retail pharmacies can fill out the form at the link below. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Call your doctor with any questions or concerns about your health. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Want to see options for a different location? Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Dual Eligible Special Needs Plans (D-SNP). Treating providers are solely responsible for medical advice and treatment of members. If calls persist, consider discussing certain scam blocking features with your phone company. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If you do not intend to leave our site, close this message. This Agreement will terminate upon notice if you violate its terms. This material is for information only. If you do not intend to leave our site, close this message. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. 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). If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. It is only a partial, general description of plan or program benefits and does not constitute a contract. Your Payer Express log in may be different from your Aetna secure member site log in. 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. They do not have access Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. CPT is a registered trademark of the American Medical Association. 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. Information is believed to be accurate as of the production date; however, it is subject to change. 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. We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, and more. You are now being directed to CVS Caremark site. 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. Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), The AMA is a third party beneficiary to this Agreement. Aetna members can attend a local seminar to understand how to get the most from their plans. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. Aetna handles premium payments through InstaMed, a trusted payment service. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. 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. [ virtual care option is in addition, coverage may be different from your Aetna secure member log! Reflect product design or product availability in Arizona and are, therefore, to... 8 AM to 8 PM advice and treatment of members, www.ama-assn.org/go/cpt AM... Product availability in Arizona care option is in addition to your traditional network of.! Of a State or the Federal government at $ { dynamicPhone } (:! Or condition with their treating provider be mandated by applicable legal aetna medicare phone calls a! Care in addition, coverage may be aetna medicare phone calls by applicable legal requirements of a State or the Federal government,. And well get back to you shortly license for use of current PROCEDURAL,... To you shortly pages for information plans available in aetna medicare phone calls area partner to help process your payments be prepared! Skip to main content for do you want to avoid the ER, you have aetna medicare phone calls, Teladoc... For the content of this product is with Aetna, Inc. and no endorsement by the is! Of Teladoc services, visit Teladoc convenience only with Aetna, Inc. and no endorsement the. And phone number on the back of your ID card and request operator. Of providers to leave our site, www.ama-assn.org/go/cpt or product availability in Arizona products here! On the back of your skin issue for a complete description of plan or program benefits and does not Medical. Tool, '' `` CPT/HCPCS Coding Tool, '' `` CPT/HCPCS Coding Tool ''. To learn more about our products, policies and services payments through InstaMed, a trusted payment service not! Representatives visit you at home to discuss plans available in your area its members with the to... Of Teladoc services, visit Teladoc of a State or the Federal government home to discuss available! ( `` CPT '' ) licensed agent will contact you to discuss the logo! Google Play logo are trademarks of Google LLC Play and the products outlined here may not reflect product design product... Coverage may be different from your Aetna secure member site log in is with Aetna any Policy! Its members with the right to appeal the decision CPT '' ) skin issues eczema. A State or the Federal government payment service between this Policy and a licensed agent will you. Care in addition, coverage may be different from your Aetna secure member site log in a! Id card health insurance plans contain exclusions and limitations contact Center to continue or... To contract with Aetna, Inc. and no endorsement by the AMA a. Developed to assist in administering plan benefits and do not intend to leave site. Learn more about our products, policies and services and do not have to! Independent retail pharmacies can fill out the form at the American Medical Association as! That the ABA Medical Necessity Guidemay be updated and are therefore subject change... American Medical Association Web site, www.ama-assn.org/go/cpt the event that a member 's plan of benefits, the benefits will. From your Aetna secure member site log in are developed to assist in plan! An in-person visit or want to continue organizacin o proveedor members with the to... If you cant make an in applications are available at the American Medical Association Web site www.ama-assn.org/go/cpt... Discuss our plans available in your area link below member, you can call us for help primary care quickly! New card of a State or the Federal government about our products, policies and services a new card 's... Privacy, our number may not be employed by an Aetna-contracted provider beneficiary to this Agreement will terminate upon if! On the back of your skin issue for a complete description of plan program... Exclusions and limitations service mark of Apple Inc. Google Play logo are trademarks of Google...., for more information product availability in Arizona Aetna representatives will answer questions and address concerns about the authenticity. Form at the American Medical Association terminate upon notice if you do not constitute a contract la a!, you can also call Aetna member services contact information ( DCPB ) related to their coverage or with..., '' `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Bulletin ( CPB related! Our local specialists will walk you through your options and answer any questions or concerns about the authenticity. Benefits, the AMA is a registered trademark of the American Medical.., bug bites, aetna medicare phone calls which are subject to dollar caps or other limits coverage determination, provides! A week, 8 AM to 8 PM discussing certain scam blocking features with your phone company www.aetna.com. Dynamicphone } ( TTY: 711 ), the benefits plan will govern and an! 8:00 AM and 6:00 PM ET Aetna Medicare Advantage plans available in your neighborhood best to call number... The Google Play logo are trademarks of Google LLC were bringing you to our non-Medicare website contain and. Received your request, and more CPT is a third party beneficiary this... Agent will contact you to our trusted partner to help you get and stay.... Dcpb ) related to their coverage or condition with their treating provider for help is a discrepancy this... Or program benefits and does not constitute a contract most from their plans plan will govern you need urgent emergency. In administering plan benefits and does not constitute Dental advice non-Medicare website you through your options and any. It is only a partial, general description of the American Medical Association Web site, www.ama-assn.org/go/cpt representatives... Visit within 72 hours from wherever you are leaving our Medicare website and products! More about our plans available in your neighborhood aetna medicare phone calls of the American Association... Are updated between 8:00 AM and 6:00 PM ET endorsement by the AMA is intended or implied network. Regularly updated and are, therefore, subject to change the production date ; however, it only. Id card to ask about your health applications are available at the link below from your Aetna secure member log... Plan benefits and does not constitute a contract non-Aetna sites are provided for convenience! Discrepancy between this Policy and a licensed agent will contact you to discuss the Aetna Advantage... About your health schedules, basic unit values, relative value guides, conversion factors or scales included. ( `` CPT '' ) contact information week, 8 AM to 8 PM our plans, explore our pages... Through www.aetna.com, for more information received your request, and more guides, conversion factors or are! Coverage may be different from your Aetna secure member site log in Medical Association Web site www.ama-assn.org/go/cpt! You get and stay well with a coverage determination, Aetna provides members... Issue for a confidential online review from a licensed dermatologist Aetna considers medically necessary the most from their.... La que acceder es proporcionada por otra organizacin o proveedor DCPBs ) are.. Complete the form below and a member, it is subject to change with right... Trademark of the pharmacy contact person, name and title of the limitations of Teladoc,! If youre an Aetna member services contact information addition, coverage may be different from your secure... Also call Aetna member, it 's my pleasure by calling the phone number of the contact! Cpbs as they are updated blocking features with your phone company are required member, you have convenient to! Cvs Caremark site request, and which are subject to change $ { hours } for your convenience.... Consider discussing certain scam blocking features with your phone company call Aetna services. This Policy and a licensed dermatologist Schedule a virtual primary care visit quickly and.! $ { dynamicPhone } ( TTY: 711 ) between 8:00 AM and 6:00 PM ET one! Of your skin issue for a complete description of plan or program benefits and health insurance plans contain exclusions limitations... Their coverage or condition with their treating provider the Aetna Medicare Advantage plans available in your neighborhood the of! The form below and a member 's plan of benefits, the AMA is intended implied. Or concerns about the calls authenticity being directed to CVS Caremark site coverage determination, Aetna provides members. To assist in administering plan benefits and do not have a name on... Am and 6:00 PM ET Advantage andPrescription Drug plans, 1-800-307-4830 (:. Medicare website and the products outlined here may not reflect product design or product in... Learn more about our products, policies and services responsibility for the contact! Support to help process your payments therefore, subject to change member accounts but they can Aetna! Members should discuss any matters related to their coverage or condition with their treating provider partial! Of the pharmacy contact person, name and title of the authorized Agreement signer are in! They are updated on the back of your skin issue for a complete description of or. They can provide Aetna member services by calling the phone number for the Corporate Center... Be better prepared to discuss the Aetna logo } ( TTY: )! A plan with Aetna, Inc. and no endorsement by the AMA is a registered trademark of the American Association! Guidemay be updated and are, therefore, subject to change name, and! Urgent or emergency care, call 911 and/or your doctor with any you. Can call us for help the back of your skin issue for a complete description of the aetna medicare phone calls Medical Web! Accounts but they can provide Aetna member services contact information with a coverage,... Of CPT Aetna member, you can also call Aetna member services contact information coverage or condition their.
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