Mail to: 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. No fee schedules, basic unit, relative values or related listings are included in CPT. WebBhh Aetna Cleaners & Laundry, LLC in Coral Gables, FL | Company Info The information on this page is being provided for the purpose of informing the public about a matter of genuine public interest. If they dont select a PCP, we may select one for them. 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). CPT only Copyright 2022 American Medical Association. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. 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. Treating providers are solely responsible for medical advice and treatment of members. Aetna PO Box 14067 For language services, please call the number on your member ID card and request an operator. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Unlisted, unspecified and nonspecific codes should be avoided. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Fir plywood Marine A/B 3/4" x 48" x 96". 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. Go to the American Medical Association Web site. 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. These MA PPO plans provide all the benefits of Original Medicare and more, such as unlimited hospitalization and coverage for certain preventive services. Treating providers are solely responsible for medical advice and treatment of members. Be sure to have your student ID number. 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. 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. WebAetna Dental P.O. Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. 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). All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. LEXINGTON KY 40512 800-548-3945, P O BOX 14089 79998-1106, Aetna Student HealthSM ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. With respect to bundling/unbundling logic, we use the Correct Coding Initiative (NCCI). You are now being directed to the CVS Health site. 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. Aetna New and revised codes are added to the CPBs as they are updated. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. If an application is submitted without all of the required information, this will cause a processing delay. 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). 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. New and revised codes are added to the CPBs as they are updated. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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). All the contents and articles are based on our search and taken from various resources and our knowledge in Medical billing. All Rights Reserved to AMA. 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. event () async def on_message (message): if message. We try to keep it updated as per recent and latest updates from the authorized source of information, if any discrepancy is found please contact via contact us page. Precertification is recommended, but not required. Simplified billing submit one bill to Aetna and receive one remittance. 151 Farmington Avenue The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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). CPT is a registered trademark of the American Medical Association. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. The Provider Service Center helps with benefits, claims and many other questions. 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. You are a COBRA participant in the ExxonMobil Medicare Supplemental Plan. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. We are expecting an increase in membership for our Medicare Advantage (MA) preferred provider organizations (PPOs). Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Members should discuss any matters related to their coverage or condition with their treating provider. 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. For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. Insurance Denial Claim Appeal Guidelines. PO Box 14579 In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Whatever you need help with, you can find us using the contact information below. Please log in to your secure account to get what you need. 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. 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. 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. Boston, MA 02215-0014 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. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. You are now being directed to the CVS Health site. WebAetna Better Health Illinois Claims Mailing Address Health (3 days ago) Web (3 days ago) WebAetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Aetna meritain claims address and Phone number: https://www.health-improve.org/aetna-better-health-illinois-claims-mailing-address/ 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. Unlisted, unspecified and nonspecific codes should be avoided. Box 14079 In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. 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