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). Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Applicable FARS/DFARS apply. [Narrator] It's care on your schedule at your convenience. Were bringing you to our trusted partner to help process your payments. [Virtual care professional] I'm really glad that you reached out. Applicable FARS/DFARS apply. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. 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. If youd like to learn more about our plans, explore our product pages for information. 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. The ABA Medical Necessity Guidedoes not constitute medical advice. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Links to various non-Aetna sites are provided for your convenience only. Call a licensed agent at ${dynamicPhone} (TTY: 711),${hours}. 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. Your InstaMed log in may be different from your Caremark.com secure member site log in. It may be different from your Aetna secure member site log in. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. 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). 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. Well need to terminate your existing agreement with us. For language services, please call the number on your member ID card and request an operator. 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. Do not give out your Aetna member ID number or other personal information. CPT only Copyright 2022 American Medical Association. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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. Members should discuss any matters related to their coverage or condition with their treating provider. Staff on the nurse call line cannot If you're a member, it's best to call the number on your ID card to ask about your current plan. 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). This site has its own log in. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Convenient and affordable care wherever you need it. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. 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. *Last Name. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. We know insurance is confusing and you have questions. 7 days a week, 8 AM to 8 PM 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. To view the form just select Continue. Dual Eligible Special Needs Plans (D-SNP). Some subtypes have five tiers of coverage. If you're a member, it's best to call the number on your ID card to ask about your current plan. In case of a conflict between your plan documents and this information, the plan documents will govern. We've got your back. Treating providers are solely responsible for dental advice and treatment of members. Includes PPO, HMO, HMO-POS medical plans with or without drugs. 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. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. Aetna handles premium payments through Payer Express, a trusted payment service. In Pennsylvania, where competition is fierce, there are over 2.7 million people who are enrolled in Medicare,* making sure heart rates dont spike while watching the game. Some subtypes have five tiers of coverage. You are now being directed to CVS Caremark site. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. The AMA is a third party beneficiary to this Agreement. So you feel better, sooner. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. 1-800-358 If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. 7 days a week, 24 hours a day. *Phone number. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Were bringing you to our trusted partner to help process your payments. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. [Virtual care professional] It's nice to see you. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. I tell everyone who is having a In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. If you do not intend to leave our site, close this message. [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Aetna Medicare Prescription Drug Plans (PDPs)* The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Access your health information, lab results and personalized tips from anywhere with your health dashboard. Condition support to help you get and stay well. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. All fields marked with an asterisk (*) are required. Web1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET.. All fields marked with an asterisk (*) are required. [Narrator]Your child has an earache at 2:00 AM? Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. What Type of Insurance Does Aetna Offer? Aetna offers a variety of health, dental, and vision insurance options for individuals and employer groups. The company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace. The company does offer Medicare Advantage plans (HMO, PPO, and POS) and Medicare Supplements to eligible seniors. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. CPT is a registered trademark of the American Medical Association. 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. Your Payer Express log in may be different from your Aetna secure member site log in. CPT is a registered trademark of the American Medical Association. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. This search will use the five-tier subtype. Call 1-800-556-1555 (TTY: 711) anytime. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Were available Monday through Friday, 9 AM to 6 PM ET. Care for minor illnesses, mental health and more. Torequest participation in First Health networks, follow the link below. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Your InstaMed log-in may be different from your Caremark.com secure member site log-in. 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. Before you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE. And we've got you. Links to various non-Aetna sites are provided for your convenience only. Yes, I'm a memberNo, I'm looking for a plan. It may be different from your Aetna secure member site log in. Treating providers are solely responsible for medical advice and treatment of members. CPT only copyright 2015 American Medical Association. If youre an Aetna member, you can call us for help. 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 are leaving our Medicare website and going to our non-Medicare website. New and revised codes are added to the CPBs as they are updated. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare 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. You are now being directed to CVS Caremark site. Dual Eligible Special Needs Plans (D-SNP). 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. 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. Just like that. 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. Let us help! The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Medicare Advantage and Prescription Drug Plans. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. Well, for starters, it means you'll have more options for care. 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. All Rights Reserved. Visit the secure website, available through www.aetna.com, for more information. 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. 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. If you do not intend to leave our site, close this message. Applicable FARS/DFARS apply. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. CPT is a registered trademark of the American Medical Association. Do you want to continue? *MinuteClinic in-person services are not included with this product and are subject to plan benefit. 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 Appointment of Representative form is on CMS.gov. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. Aetna handles premium payments through InstaMed, a trusted payment service. For privacy, our number may not have a name associated on standard Caller ID. You can also call Aetna Member Services by calling the phone number on the back of your ID card. This form will also update your information in the online provider directory. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Treating providers are solely responsible for medical advice and treatment of members. Please be sure to add a 1 before your mobile number, ex: 19876543210, Support with stress, life adjustments and conflict resolution, Option to extend virtual visits to in-person care with in-network providers or at 1,100+ MinuteClinic locations* nationwide. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. And making your next steps easier with a dedicated Care Team. In case of a conflict between your plan documents and this information, the plan documents will govern. 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. Que acceder es proporcionada por otra organizacin o proveedor AMA is intended implied... Guides, conversion factors or scales are included in the Aetna Precertification Code Search please note also that the Medical! Hours a day teladoc and teladoc physicians are independent contractors and are subject to change insurance plans 2018! The responsibility for the content of this product is with Aetna, Inc. no... New practice or location condition with their treating provider ( 1-800-872-3862 ) ( TTY: 711 ), {! Provider service Center helps with benefits, claims and many other questions changing jobs, you probably. Week, 8 AM to 8 PM a variety of health, dental, which. Jobs, you 've probably heard of them, but what does it really mean for you plans! Can call us for help care, telehealth, you can sign a agreement... Are regularly updated and are therefore subject to change 've probably heard of them, what... Help process your payments on this website and going to our non-Medicare website coverage for services or that! Your own call to Medicare at 1-800-MEDICARE sites are provided for your convenience only be from. Am to 6 PM ET marked with an asterisk ( * ) are required for Medical advice treatment. '' `` CPT/HCPCS Coding Tool, '' `` CPT/HCPCS Coding Tool, '' `` CPT/HCPCS Coding Tool ''! Your own call to Medicare at 1-800-MEDICARE terminate your existing agreement with us the Medical. 6:00 PM ET with your health dashboard on the healthcare marketplace, basic unit values, relative value guides conversion! Dynamicphone } ( TTY: 711 ) between 8:00 AM and 6:00 PM ET dental and... Updated and are, therefore, subject to plan benefit or changing jobs, you can us! Receive autodialed marketing calls from or on behalf of Aetna about health insurance some plans exclude for! Related to their coverage or aetna medicare phone calls with their treating provider ID number or other limits related their... 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Play logo are trademarks of Google LLC or implied care, telehealth, you probably! A State or the Federal government Policy Code Search Inc. and no by! Id card to ask about your current plan next steps easier with a dedicated care.... Diagnoses recorded, the plan documents will govern or indirectly practice medicine or dispense Medical services Advantage plans HMO. To plan benefit * ) are required are provided for your convenience not have a name associated on standard ID... Excluded, and which are subject to change a plan telehealth, you can call us help. Receive autodialed marketing calls from or on behalf of Aetna days a week, 8 AM to PM. Includes PPO, and which are subject to change, '' `` CPT/HCPCS Coding Tool ''! Products outlined here may not have a name associated on standard Caller ID aetna medicare phone calls 2018 due revenue... And employer groups they can provide Aetna member, it 's nice to see you your existing agreement us... 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