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. 40512-4079, State Health benefits and health insurance plans contain exclusions and limitations. 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. Lexington, KY Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Mail the claim to Meritain Healths claims address listed on the members ID card. The AMA is a third party beneficiary to this Agreement. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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 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. 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. 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. 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. Include payment information received from the primary payers HIPAA standard electronic remittance advice (ERA) or convert the primary payers payment information received on an Explanation of Benefits (EOB) into standard coding used in an ERA. If you missed Open Enrollment, Already a member? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. CPT only copyright 2015 American Medical Association. Lexington, KY 40512. 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. WebContact Aetna Member login Get in touch Heres the place to get your questions answered about plan features, tools, costs and more. CO, CT, DC, DE, IA, IL, IN, KS, KY, If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. All Rights Reserved. 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. 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. Health Savings Account Tools and Information. The primary care ID will be listed with that particular PCP in the directory. Do you want to continue? CPT is a registered trademark of the American Medical Association. 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. Before implement anything please do your own research. The member's benefit plan determines coverage. Designed by Elegant Themes | Powered by WordPress. 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. Copyright 2015 by the American Society of Addiction Medicine. If your claim rejects at the vendor level, contact your vendor. Provide the patients name, relationship to the covered person, Member ID number or Social Security number, sex and date of birth. We want to make it easier for you to live healthier. If necessary, use the following claims billing addresses. Machine Readable Data Provider Network Content for Federally-Facilitated Marketplace (FFM) Qualified Health All the information are educational purpose only and we are not guarantee of accuracy of information. full name (first and last name)address/zip code/email/etc. (you might need to provide some information to confirm your identity)date of birthsocial security numberhealth insurance policy numbermember number (Aetna member number)your billing information (if the question is about a bill) 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. Visit the secure website, available through www.aetna.com, for more information. Call Aetna Member Services: 1-855-339-9731 (TTY: 711) Monday through Friday, 7 AM to 5 PM CT Health 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. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. 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. This information is neither an offer of coverage nor medical advice. 800-566-9311Aetna coresource claims address and Phone NumberAetna, Inc. P O Box 981107El Paso, TX 79998-1107800-793-8616Aetna credentialing phone number800-353-1232if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'medicalbillingrcm_com-medrectangle-4','ezslot_11',340,'0','0'])};__ez_fad_position('div-gpt-ad-medicalbillingrcm_com-medrectangle-4-0'); Aetna claim address and Aetna phone numbers are very important to handling denials, AR follow-up and claim submission. Copyright 2015 by the American Society of Addiction Medicine. Attachments arent necessary. 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to Some subtypes have five tiers of coverage. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Review reports promptly to identify any items that require attention. If you have questions regarding the status of a claim (for instance, whether it has been paid or processed), use our Claim Status Inquiry transaction. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Fir plywood Marine A/B 3/4" x 48" x 96". 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. Aetna This is the phone number Some subtypes have five tiers of coverage. 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 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. All Rights Reserved to AMA. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The member's benefit plan determines coverage. 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. New and revised codes are added to the CPBs as they are updated. Have questions about our products, policies and services? CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. WebTo learn more about Aetna Senior Supplemental Insurance and our products, you can call, email or write us. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Visit the secure website, available through www.aetna.com, for more information. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. P.O. 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. Submit a separate claim form for each eligible family member. It's easy to update a provider address, phone number, fax number, email address or initiate an out-of-state move or a change in provider group. Medicare Supplement Insurance plans. NAIC Coordination of Benefits Policy. Please log in to your secure account to get what you need. ID card Medicare PPO is indicated in the upper corner of the ID card (see the example on page 2). 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