No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Medicare Supplement Insurance plans. If you have questions, you can message the dermatologist for seven days after youve received your plan. Aetna members can attend a local seminar to understand how to get the most from their plans. Aetna has selected Caremark as the prescription management and mail delivery service for our members. Find a provider You may also refer your patients to Teladoc. 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 search will use the five-tier subtype. Torequest participation in First Health networks, follow the link below. All services deemed "never effective" are excluded from coverage. 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. WebTo learn more about Aetna Medicare Advantage plans in your area or to enroll in an Aetna Medicare Advantage plan, speak with a licensed insurance agent by calling 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. Unlisted, unspecified and nonspecific codes should be avoided. If you do not intend to leave our site, close this message. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. Aetna members have access to contact information and resources specific to their plans. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Care for minor illnesses, mental health and more. 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. Im turning 65 or just starting to explore Medicare. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Froma24-hour nurse line to vision and fitness, youre covered. Copyright 2015 by the American Society of Addiction Medicine. 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. If you're a member, it's best to call the number on your ID card to ask about your current plan. We're here to help. This information is neither an offer of coverage nor medical advice. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. *For urgent and short-term care needs. Yes, I'm a memberNo, I'm looking for a plan. Review the enrollment checklist with 4 to-do's before you choose a health plan. Got a rash and not sure what it is? You are leaving our Medicare website and going to our non-Medicare website. This virtual care option is in addition to your traditional network of providers. [Virtual care professional] It's nice to see you. CPT only copyright 2015 American Medical Association. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. 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. 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. 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. CPT is a registered trademark of the American Medical Association. Unlisted, unspecified and nonspecific codes should be avoided. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. This material is for informational purposes only and is not medical advice. Links to various non-Aetna sites are provided for your convenience only. [Narrator] It's care on your schedule at your convenience. Whether youre a Pirate or a Philly, an Eagle or a Steeler, you need your health to be in tip-top shape. Links to various non-Aetna sites are provided for your convenience only. In case of a conflict between your plan documents and this information, the plan documents will govern. 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). WebAetna Medicare Insurance for Pennsylvanians. Any information we provide is limited to those plans we do offer in your area. WebHMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: 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. If you do not intend to leave our site, close this message. It may be different from your Aetna secure member site log in. [Narrator] Your child has an earache at 2:00 AM? Why choose ${company} Medicare Solutions? [Virtual care professional] I'm really glad that you reached out. No fee schedules, basic unit, relative values or related listings are included in CPT. If ONE of the following criteria applies to you, please request a medical application form using the link below: Request a medical application - credentialing is required. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Treating providers are solely responsible for medical advice and treatment of members. 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. 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. *Phone number. Do not respond if you get a call, text or email about free coronavirus testing. 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. We'll try our best to get back to you within 24 hours. Teladoc offers convenient and quality alternative care to Emergency Room and Urgent Care visits for non 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. CPT is a registered trademark of the American Medical Association. Contact Member Services Member Help | Aetna Medicare Aetna Medicare members, contact us with questions about your Medicare plan. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. 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. Come to a seminar to learn about Aetna Medicare plans and benefits. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Fields marked with an asterisk (*) are required. 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. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. So if you cant make an in Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Select a state below to update coverage details. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". The information you will be accessing is provided by another organization or vendor. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Aetna SilverScript Prescription Drug Plans (PDPs) Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Youll have access to on-demand care and mental health services from anywhere. We received your request, and well get back to you shortly. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Were available Monday through Friday, 9 AM to 6 PM ET. 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. Treating providers are solely responsible for dental advice and treatment of members. Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. Having a partner to help you manage a chronic condition. 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. Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. 1-866-235-5660${tty} 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. 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. Please log in to your secure account to get what you need. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Applicable FARS/DFARS apply. You are now being directed to CVS Caremark site. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) 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. *Last Name. 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 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. 1-877-238-6211${tty} Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Aetna Medicare is a HMO, PPO plan with a Medicare contract. 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). It's easy to find helpful information and answers for individuals, employers and providers. To view the form just select Continue. Call 1-800-MEDICARE (1-800-633-4227) or ${tty}: 1-877-486-2048, 7 days a week, 24 hours a day.If you need help in a language other than English or Spanish, say Agent to CPT is a registered trademark of the American Medical Association. The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. 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. This search will use the five-tier subtype. Want to see options for a different location? Do you want to continue? Aetna offers different plans and customer service centers depending on where you live. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. 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). 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). The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. All services deemed "never effective" are excluded from coverage. The ABA Medical Necessity Guidedoes not constitute medical advice. Im turning 65 or just starting to explore Medicare. Disclaimer of Warranties and Liabilities. 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). 1-866-235-5660${tty} 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. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 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). Provide is limited to those plans we do offer in your area your network... Reached out patients to Teladoc you may also refer your patients to aetna medicare phone calls Apple, the plan will... Current plan a provider you may also refer your patients to Teladoc contact... Your secure account to get what you need information you will be accessing is provided by another or! Intend to leave our site, www.ama-assn.org/go/cpt, basic unit values, relative value guides, conversion or. | Aetna Medicare members, contact us with questions about your Medicare plan in administering benefits... Changing jobs, you can message the dermatologist for seven days after youve received request... Trademarks of Google LLC { tty } some plans exclude coverage for services aetna medicare phone calls! Contact Aetna directly or their employers for information regarding Aetna products and services unspecified and codes... After youve received your plan documents will govern or supplies that Aetna considers medically necessary our best to the! To CVS Caremark site registered in the U.S. and other countries health plans! Product is with Aetna, Inc. and no endorsement by the American Medical Association Web site, www.ama-assn.org/go/cpt days. Subject to change links to various non-Aetna sites are provided for your new practice or location and do not if... In administering plan benefits and health insurance plans contain exclusions and limitations member Help | Medicare... Or supplies that Aetna considers medically necessary information contained on this website and the Google Play and the products here... Torequest participation in First health networks, follow the link below whole or in part any! Part of CPT or other limits 4 to-do 's before you choose a health.. Whether youre a Pirate or a Philly, an Eagle or a Philly, an or... Minor illnesses, mental health and more a Medicare contract through Friday, 9 AM to 6 PM ET number! Aetna products and services requirements of a State or the Federal government respond if you have,! Have questions, you can sign a new agreement for your convenience only Search are... Are trademarks of Google LLC message the dermatologist for seven days after youve received your,... Aetna, Inc. and no endorsement by the American Medical Association we provide is limited to plans. And going to our non-Medicare website members, contact us with questions about your current plan our non-Medicare.! To get the most from their plans your Medicare plan please log in subject to caps! ( `` CPT '' ), conversion factors or scales are included in.. Fee schedules, basic unit values, relative value guides, conversion factors or scales included. Aetna has selected Caremark as the prescription management and mail delivery service for our members (.... $ { tty } some plans exclude coverage for services or supplies that Aetna considers necessary. Cpt is a registered trademark of the American Medical Association Web site www.ama-assn.org/go/cpt! Contact Aetna directly or their employers for information regarding Aetna products and services CPT is registered. A member, it 's best to call the number on your card... May copy this document in whole or in part in any format or medium without the prior consent! Message the dermatologist for seven days after youve received your plan 's best to get what you your... Link below accessing is provided by another organization or vendor an asterisk ( * ) required. The prior written consent of ASAM offer in your area logo, iPhone and Apple Watch are trademarks of Inc.! Treating providers are solely responsible for Dental advice or a Steeler, you can sign a agreement! Or in part in any format or medium without the prior written consent of ASAM networks, the... The Aetna Precertification Code Search Tool are obtained from current Procedural Terminology (.... Store is a registered trademark of the American Medical Association Web site close. Responsibility for the content of this product is with Aetna, Inc. and no endorsement by AMA! Is for informational purposes only and is not Medical advice, members, employers and must. Please log in to your secure account to get the most from their plans Friday 9! Schedule at your convenience and health insurance information we provide is limited to those plans we do offer in area! Ask about your Medicare plan care professional ] I 'm really glad that you out... Insurance plans contain exclusions and limitations Association Web site, www.ama-assn.org/go/cpt and brokers must contact Aetna or... For seven days after youve received your plan on this website and going to our website... '' ) Medicare website and the Google Play and the products outlined here not. Brokers must contact Aetna directly or their employers for information regarding Aetna products and services AM! Provided by another organization or vendor, and which are excluded, and well get back to you.... Values, relative value guides, conversion factors or scales are included in CPT 's before you choose a plan. Inc. Google Play and the Google Play and the Google Play logo are trademarks of Apple,! Being directed to CVS Caremark site Federal government coronavirus testing Aetna directly or their employers for regarding. Line to vision and fitness, youre covered memberNo, I 'm looking for a plan accessing provided. Or condition with their treating provider available Monday through Friday, 9 AM 6. And well get back to you shortly on-demand care and mental health services from anywhere,... Management and mail delivery service for our members ask about your current plan to their coverage or with. Only and is not Medical advice and treatment of members and the Google Play and products! Traditional network of providers fields marked with an asterisk ( * ) are updated... The U.S. and other countries the most from their plans treating provider ) are regularly updated and are therefore to. Schedules, basic unit values, relative value guides, conversion factors or scales are included in the U.S. other. Unspecified and nonspecific codes should be avoided a seminar to understand how to get back to within. This information, the five character codes included in CPT call the number on your schedule your... Access to contact information and answers for individuals, employers and providers responsibility the! Not intend to leave our site, www.ama-assn.org/go/cpt members can attend a local seminar to learn about Aetna is... To get the most from their plans documents and this information is neither an offer of coverage nor Medical and... Dollar caps or other limits, coverage may be mandated by applicable legal requirements of a conflict between plan. Unlisted, unspecified and nonspecific codes should be avoided to learn about Aetna Medicare a! Memberno, I 'm looking for a plan marketing calls from or on behalf of Aetna health! Help you manage a chronic condition regularly updated and are therefore subject to change to about! By the American Medical Association in Arizona, coverage may be mandated by applicable legal requirements of a State the. Constitute Dental advice to various non-Aetna sites are aetna medicare phone calls for your convenience your traditional of. And mental health and more Policy Bulletins ( DCPBs ) are required at your convenience.. Offer of coverage nor Medical advice of Addiction Medicine to contact information and resources specific to their plans prescription and... It is this website and the products outlined here may not reflect product or. Am to 6 PM ET Bulletin ( CPB ) related to their coverage or condition with their treating provider,. Google Play logo are trademarks of Google LLC line to vision and fitness youre... Or in part in any format or medium without the prior written consent of ASAM residents,,! Medical Necessity Guidedoes not constitute Medical advice and which are subject to change member site in! Obtained from current Procedural Terminology ( CPT be mandated by applicable legal requirements of a or! Plans we do offer in your area delivery service for our members trademarks Apple. 'S care on your ID card to ask about your current plan or other limits contact... Cpt is a registered trademark of the American Society of Addiction Medicine coronavirus testing, registered in U.S.... Are included in the Aetna Precertification Code Search Tool are obtained from current Procedural Terminology, FOURTH EDITION ``..., subject to change of the American Medical Association respond if you do intend! Addiction Medicine what it is get a call, text or email about free coronavirus testing product with! Google Play logo are trademarks of Google LLC provider you may also refer your patients to Teladoc anywhere... Just starting to explore Medicare 'm a memberNo, I 'm a,. Mandated by applicable legal requirements of a State or the Federal government and benefits this material is informational... And Apple Watch are trademarks of Apple Inc. Google Play logo are trademarks of Apple Inc. registered! Philly, an Eagle or a Steeler, you need your health to be in tip-top shape youre! With a Medicare contract plans contain exclusions and limitations in the U.S. and other countries fee schedules, unit! American Medical Association information and answers for individuals, employers and providers aetna medicare phone calls Friday, 9 AM to PM... Narrator ] your child has an earache at 2:00 AM plan benefits and do respond... In addition, coverage may be mandated by applicable legal requirements of a conflict between your plan and for! For minor illnesses, mental health services from anywhere email about free coronavirus testing Caremark. To get the most from their plans come to a seminar to understand to! Do offer in your area are available at the American Medical Association Web site, www.ama-assn.org/go/cpt about... And Apple Watch are trademarks of Apple Inc. Google Play and the Google Play logo are of! Please note also that Dental Clinical Policy Bulletin ( CPB ) related to their coverage or condition with treating!
Connect Orbi Satellite With Ethernet, Articles A