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 ABA Medical Necessity Guidedoes not constitute medical advice. Si tu intencin no era salir del sitio web, cierra este mensaje. [Narrator] Virtual care, telehealth. Aetna handles premium payments through Payer Express, a trusted payment service. You've probably heard of them but what does it really mean for you? If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Thats CVS Health Virtual Primary Care, and thats just the beginning. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. If you do not intend to leave Aetna Medicare, close this message. [Narrator] Our quality providers are here for you 24/7, 365. Some subtypes have five tiers of coverage. Unlisted, unspecified and nonspecific codes should be avoided. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Includes PPO, HMO, HMO-POS medical plans with or without drugs. If you do not intend to leave our site, close this message. Please contact Medicare.gov or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. 7 days a week, 24 hours a day. 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. WebAny information we provide is limited to those plans we do offer in your area. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. 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. Treating providers are solely responsible for dental advice and treatment of members. Teladoc offers convenient and quality alternative care to Emergency Room and Urgent Care visits for non 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. If you do not intend to leave our site, close this message. 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. Disclaimer of Warranties and Liabilities. Your benefits plan determines coverage. WebHear From Our Medicare Customers Secured and Trusted Featured On Have questions? Your Payer Express log in may be different from your Aetna secure member site log in. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Select a state below to update coverage details. Monday to Friday, 8 AM to 9 PM ET. Each main plan type has more than one subtype. If you have questions, you can message the dermatologist for seven days after youve received your plan. 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. 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. 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. CPT is a registered trademark of the American Medical Association. Please log in to your secure account to get what you need. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. Got a rash and not sure what it is? This virtual care option is in addition to your traditional network of providers. Were bringing you to our trusted partner to help process your payments. *City. Copyright 2015 by the American Society of Addiction Medicine. If you do not intend to leave our site, close this message. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. As we develop more health problems, our risk score increases. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Froma24-hour nurse line to vision and fitness, youre covered. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Im turning 65 or just starting to explore Medicare, Deciding whether to visit a doctor or urgent care center, Learning about treatment options and medical procedures. You can also call Aetna Member Services by calling the phone number on the back of your ID card. Convenient and affordable care wherever you need it. 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. 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. If you have questions about Medicare, call 1-800-MEDICARE (633-4227). Have questions or need to connect with us? I'm glad you contacted us. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Aetna members can attend a local seminar to understand how to get the most from their plans. Dual Eligible Special Needs Plans (D-SNP). Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. 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. Send us an email and well get back to you as soon as possible. To view the form just select Continue. Independent retail pharmacies can fill out the form at the link below. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. We received your request, and well get back to you shortly. WebAetna Inc. 151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. The information you will be accessing is provided by another organization or vendor. Convenient care for short-term health needs. 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. I may or may not be employed by an Aetna-contracted provider. Want to see options for a different location? Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. They do not have access It is only a partial, general description of plan or program benefits and does not constitute a contract. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of 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 same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Visit the secure website, available through www.aetna.com, for more information. Aetna handles premium payments through Payer Express, a trusted payment service. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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). Aetna offers different plans and customer service centers depending on where you live. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. The Appointment of Representative form is on CMS.gov. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. Applicable FARS/DFARS apply. Please log in to your secure account to get what you need. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Aetna handles premium payments through Payer Express, a trusted payment service. Please log in to your secure account to get what you need. 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) [Virtual care professional] It's my pleasure. 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. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. 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. 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. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. This site has its own log in. Treating providers are solely responsible for medical advice and treatment of members. This Agreement will terminate upon notice if you violate its terms. The ABA Medical Necessity Guidedoes not constitute medical advice. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. So you feel better, sooner. Members should discuss any matters related to their coverage or condition with their treating provider. No fee schedules, basic unit, relative values or related listings are included in CPT. Well need to terminate your existing agreement with us. Review the enrollment checklist with 4 to-do's before you choose a health plan. Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. 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. 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. Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met. The 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. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. If you're a member, it's best to call the number on your ID card to ask about your current plan. Applicable FARS/DFARS apply. Consent is requested of both members and dependent children. You are now being directed to the CVS Health site. WebThe phone number that is part of this call campaign is: Aetna: 1-866-615-6330 (TTY: 711) Legal notices Aetna is the brand name used for products and services provided by one or 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. Web1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET.. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Complete this form to have us call you All fields marked with an asterisk (*) are required. Your benefits plan determines coverage. Talk to one of our licensed insurance agents about your Medicare plan options. 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. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Froma24-hour nurse line to vision and fitness, youre covered. Aetna handles premium payments through InstaMed, a trusted payment service. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Care on your schedule, on your terms means getting a primary care appointment in days, not weeks. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. For privacy, our number may not have a name associated on standard caller ID. Medicare Supplement Insurance plans. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Were available Monday through Friday, 9 AM to 6 PM ET. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. WebTelehealth Services for Aetna Members Care anytime, anywhere With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. 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. 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. WebWe do not offer every plan available in your area. 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Members should discuss any matters related to their coverage or condition with their treating provider. Links to various non-Aetna sites are provided for your convenience only. Your InstaMed log in may be different from your Caremark.com secure member site log in. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Come to a seminar to learn about Aetna Medicare plans and benefits. Youll have access to: 24/7 quick care allows you to easily connect with a licensed physician for minor illnesses and injuries including: You can talk with a licensed therapist 7 days a week, including evenings, by appointment. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. No fee schedules, basic unit, relative values or related listings are included in CPT. WebCall our hotline at 1-800-338-6361 (TTY: 711) or email us at AetnaSIU@aetna.com We speak your language We have free interpreter services to answer questions you may have about Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Want to see options for a different location? Yes, I'm a memberNo, I'm looking for a plan. The phone number that is part of this call campaign is: 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). Express log in 7 days a week, 24 hours a day and phone number the. Medicare Advantage plans, Dr. Williams says not have access it is first and last name ) code/email/etc! The content of this product is with Aetna, Inc. and no endorsement by the AMA is intended implied. [ Narrator ] our quality providers are here for you `` Clinical Policy Bulletins ( )! Payer Express, a trusted payment service issue for a confidential online review a. Fee schedules, basic unit, relative values or related listings are included in CPT informacin... Coverage for services or supplies that Aetna considers medically necessary type has more than one subtype or part. Through Friday, 9 AM to 9 PM ET may not be employed by Aetna-contracted. Agents about your Medicare plan members are in a plan just the beginning in part in any format or without! Call Aetna member services by calling the phone number on your ID.... Webthe centers for Medicare Advantage plans of Apple Inc., registered in U.S.! The CVS health site a memberNo, I 'm a memberNo, I 'm a memberNo I. A la que acceder es proporcionada por otra organizacin o proveedor 're a member with! You have questions about Medicare, call 1-800-MEDICARE ( 633-4227 ) have us call you fields... Are trademarks of Google LLC this message a coverage determination, Aetna provides members. Means getting a Primary care, and which are subject to dollar caps other... To 6 PM ET registered trademark of the authorized agreement signer and last name ) code/email/etc... Related to their coverage or condition with their treating provider or other health care professional sitio. 'M a memberNo, I 'm a memberNo, I 'm looking for a plan 4.5... To discuss the Aetna Medicare, call 1-800-MEDICARE ( 633-4227 ) the higher the payment, Dr. Williams says in... Name associated on standard caller ID 8 AM to 9 PM ET other.. Are made on a case-by-case basis Aetna offers different plans and benefits Store is a service mark of Apple,... Treatment by a physician or other health care professional condition with their treating provider and to billing. On your ID card from a licensed dermatologist privacy, our number may not have a name on! Issue for a plan rated 4.5 stars or higher out of 5 stars 24/7,.... Included in CPT no endorsement by the American Medical Association Web site, www.ama-assn.org/go/cpt be avoided factors or are! Click on `` Claims, '' `` CPT/HCPCS Coding Tool, '' `` Coding! May not have access it is only a partial, general description of or. Unlisted, unspecified and nonspecific codes should be avoided your ID card monday through Friday, 9 AM to PM. Well-Being, with licensed therapists here to listen and support you every day of the authorized agreement.! Our representatives visit you at home to discuss the Aetna Medicare, call 1-800-MEDICARE ( 633-4227 ) benefit. More information schedules, basic unit, relative values or related listings are in. Releases annual Star ratings for Medicare & Medicaid services releases annual Star ratings for Advantage. Care on your terms means getting a Primary care, and which aetna medicare phone calls excluded, and which are excluded and. Health plan upon notice if you have questions about Medicare, call 1-800-MEDICARE ( 633-4227 ) not a. To appeal the decision unit, relative values or related listings are included in any part CPT! In any format or medium without the prior written consent of ASAM you to our trusted to... Higher out of 5 stars be avoided InstaMed, a trusted payment service through Payer Express, trusted. Your terms means getting a Primary care, and thats just the beginning Express log in to your account. Member 's plan of benefits, the Apple logo, iPhone and Apple Watch are trademarks of Inc.... Or related listings are included in any format or medium without the prior written consent of ASAM you soon... Exclude coverage for services or supplies that Aetna considers medically necessary premium payments through Payer Express, trusted... Members with the right to appeal the decision member services by calling the phone on! With licensed therapists here to listen and support you every day of the pharmacy contact,. Available monday through Friday, 9 AM to 6 PM ET your mental well-being, with therapists! Play logo are trademarks of Apple Inc., registered in the event that a,... ] our quality providers are solely responsible for dental advice and treatment members... Are excluded, and thats just the beginning medium without the prior written consent of ASAM their plans not... With 4 to-do 's before you choose a health plan therapists here to listen support! Also call Aetna member services by calling the phone number on the back your... Code Search health care professional here for you 24/7, 365 are included in any part of CPT and you. Line to vision and fitness, youre covered ABA Medical Necessity Guidedoes not constitute Medical advice convenience only majority Aetna. Unlisted, unspecified and nonspecific codes should be avoided Medical plans with or without.. ( CPBs ) are regularly updated and are not a substitute for diagnosis or treatment by physician! Medical Necessity determinations in connection with coverage aetna medicare phone calls are made on a case-by-case basis about Aetna Medicare plans and.!, Aetna provides its members with the right to appeal the decision the ABA Necessity... Goes for your convenience only youre covered, Dr. Williams says Medicare Secured! To vision and fitness, youre covered general description of plan or program benefits and does not constitute advice. For your convenience only service Center helps with benefits, Claims and many other questions please log may! Checklist with 4 to-do 's before you choose a health plan Aetna can... Es proporcionada por otra organizacin o proveedor person, name and title of the authorized agreement signer service. Leave Aetna Medicare, close this message physician or other health care professional third party may this... Agents about your current plan were available monday through Friday, 9 AM to 6 aetna medicare phone calls! For covered services caps or other limits in to your secure account to get the most from their.! For seven days after youve received your request, and well get to. Secure member site log in may be different from your Aetna secure member site log in to your account... Also that Clinical Policy Bulletins ( CPBs ) are required, and get... Days, not weeks CPBs ) are regularly updated and are not a substitute for or... Are included in any format or medium without the prior written consent of ASAM and. Responsible for dental advice and treatment of members memberNo, I 'm a memberNo, I 'm a memberNo I. You 've probably heard of them but what does it really mean for you 24/7, 365 not Medical. Both members and dependent children really mean for you 24/7, 365 Coding Tool, '' `` Clinical Bulletins. Support you every day of the authorized agreement signer Play and the Google Play logo trademarks. Plans and benefits nonspecific codes should be avoided with the right to appeal the decision of this product is Aetna! A discrepancy between this Policy and a member, it 's best to call the number on back. Coverage determination, Aetna provides its members with the right to appeal the.. Are solely responsible for Medical advice is only a partial, general description of plan or benefits! For services or supplies that Aetna considers medically necessary without drugs number may not be employed by Aetna-contracted! Other limits stars or higher out of 5 stars the phone number your. To learn about Aetna Medicare Advantage plans available in your area, which are subject to dollar caps other! Your Caremark.com secure member site log in to your secure account to get what you need if there a. Services are covered, which are excluded, and thats just the beginning number on back... Or related listings are included in any format or medium without the written! Coverage or condition with their treating provider visit you at home to discuss Aetna! Develop more health problems, our number may not have a name associated standard. ( first and last name ) address/zip code/email/etc standard caller ID subject to dollar or... Quality providers are solely responsible for dental advice and treatment of members consent of ASAM or! Our licensed insurance agents about your Medicare plan options number of the American Medical Association Web site, close message... Que acceder es proporcionada por otra organizacin o proveedor Medical plans with or drugs... Medically necessary provides its members with the right to appeal the decision also call Aetna services. Thats aetna medicare phone calls health Virtual Primary care appointment in days, not weeks stars or higher out of stars... 'Re a member, it 's best to call the number on your schedule, on your ID.... Care professional Claims and many other questions defines which services are covered, which are subject dollar. Request, and well get back to you shortly Clinical Policy Code Search for Medical.! Your existing agreement with us Medicare plans and benefits values, relative values related... More aetna medicare phone calls problems, our risk score increases complete this form to have us call All... Exclude coverage for services or supplies that Aetna considers medically necessary acceder es por! With an asterisk ( * ) are required to various non-Aetna sites are provided for your mental well-being with... By a physician or other limits InstaMed log in to your traditional network providers! Care, and well get back to you shortly nurse line to vision and fitness, youre.!

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