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. We're here to help. *Address. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. 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. You can cancel your Aetna life insurance policy online or by phoneAetna customer service can be reached by calling 1-800-872-3862You will need to write an Aetna termination of coverage letter, which can easily be done We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, and more. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. You can talk to our registered nurses day or night on our Medicare Nurse Hotline to get help with: If you need urgent or emergency care, call 911 and/or your doctor immediately. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. Yes, I'm a memberNo, I'm looking for a plan. 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. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Dual Eligible Special Needs Plans (D-SNP). Your Payer Express log in may be different from your Aetna secure member site log in. Includes PPO, HMO, HMO-POS medical plans with or without drugs. The information you will be accessing is provided by another organization or vendor. Members should discuss any matters related to their coverage or condition with their treating provider. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Select a state below to update coverage details. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. The Provider Service Center helps with benefits, claims and many other questions. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. 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. Links to various non-Aetna sites are provided for your convenience only. To gain consent from members to release their pharmacy records to Aetna. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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). 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. 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 Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. If you need urgent or emergency care, call 911 and/or your doctor immediately. 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. *City. Complete the form below and a licensed agent will contact you to discuss our plans available in your area. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna handles premium payments through Payer Express, a trusted payment service. 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. 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. If you have questions, reach out to your HR benefits manager. 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. 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. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. [Virtual care professional] It's nice to see you. This site has its own login. Applicable FARS/DFARS apply. Whether youve come down with a cold or need mental health counseling, CVS Health Virtual Care makes it simple. Were bringing you to our trusted partner to help process your payments. All Rights Reserved. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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). So if you cant make an in-person visit or want to avoid the ER, you have convenient support to take care of you. 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. Call us. Care for minor illnesses, mental health and more. CPT only Copyright 2022 American Medical Association. 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. Your InstaMed log in may be different from your Caremark.com secure member site log in. Case of the sneezy sniffles? [Virtual care professional] It's my pleasure. Select a state below to update coverage details. Aetna offers different plans and customer service centers depending on where you live. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. For language services, please call the number on your member ID card and request an operator. To view the form just select Continue. Access to CVS Health Virtual Care is included in your health plan through Aetna, a CVS Health Company. [Narrator] And you'll get support for more than just your physical health. It may be different from your Aetna secure member site log in. 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. All fields marked with an asterisk (*) are required. 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. All Rights Reserved. Condition support to help you get and stay well. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. Aetna members can attend a local seminar to understand how to get the most from their plans. CVS Health Virtual Care is all about you. 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. 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. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. For confidential mental health and dermatologist visits, you would need to schedule an appointment first. 3. 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 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. We received your request, and well get back to you shortly. The caller claims new cards from one of these agencies are in the works, and they need you to update your information on file. Links to various non-Aetna sites are provided for your convenience only. 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. 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. Were available Monday through Friday, 9 AM to 6 PM ET. 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). We'll try our best to get back to you within 24 hours. 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. Please log in to your secure account to get what you need. 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. 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. 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. Do not respond if you get a call, text or email about free coronavirus testing. Applicable FARS/DFARS apply. Applicable FARS/DFARS apply. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Torequest participation in First Health networks, follow the link below. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). This material is for information only. This search will use the five-tier subtype. Copyright 2015 by the American Society of Addiction Medicine. 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). And we've got you. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. Well, for starters, it means you'll have more options for care. You are now being directed to the CVS Health site. For a complete description of the limitations of Teladoc services, visit Teladoc. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Aetna Medicare is a HMO, PPO plan with a Medicare contract. Treating providers are solely responsible for medical advice and treatment of members. This Agreement will terminate upon notice if you violate its terms. [Narrator] Our quality providers are here for you 24/7, 365. Yes, I'm a memberNo, I'm looking for a plan. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. 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. This site has its own log in. Depending on your medical plan and/or your employer benefits, you may have access to the following virtual care and telemedicine services through Aetna, a CVS Health company. You cant trust caller id. 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 7 days a week, 24 hours a day. Copyright 2015 by the American Society of Addiction Medicine. 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. Go to the American Medical Association Web site. Then, get a customized treatment plan within two days. 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. Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) Health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2. This is the phone number for the Corporate Contact Center. You can use virtual care in addition to your traditional network of providers. All services deemed "never effective" are excluded from coverage. No fee schedules, basic unit, relative values or related listings are included in CPT. Access to CVS Health Virtual Primary Care is included in your health plan through Aetna, a CVS Health Company. [Narrator]Your child has an earache at 2:00 AM? This Agreement will terminate upon notice if you violate its terms. Im turning 65 or just starting to explore Medicare. Call your doctor with any questions or concerns about your health. Want to see options for a different location? The home visits conducted by Medicare Advantage plans allow for the capture of more diagnoses, which in turn increases the risk score that adjusts plan payments from Medicare. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. You can also call Aetna Member Services by calling the phone number on the back of your ID card. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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). Aetna Medicare Prescription Drug Plans (PDPs)* In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. 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. 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. Why choose ${company} Medicare Solutions? Teladoc offers convenient and quality alternative care to Emergency Room and Urgent Care visits for non Some plans exclude coverage for services or supplies that Aetna considers medically necessary. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. So you feel better, sooner. The member's benefit plan determines coverage. 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. Visit the secure website, available through www.aetna.com, for more information. Child has an earache at 2:00 AM Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated are..., 365 schedules, basic unit, relative value guides, conversion factors or scales are included in any of., 9 AM to 6 PM ET available Monday through Friday, 9 AM 6... ] it 's my pleasure, claims and many other questions customer Service depending... Members to release their pharmacy records to Aetna to get back to within., therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their for... From coverage an asterisk ( * ) are regularly updated and are not agents of Aetna Aetna secure member log... By phone the provider Service Center helps with benefits, claims and many other questions of! Medicare coverage Aetna, Inc. and no endorsement by the AMA is intended or implied down with a Medicare.... You will be accessing is provided by another organization or vendor use the logo! Medicare Helpline & Website get general or claims-specific Medicare information, request to use the logo! Excluded from coverage Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 the provider Service Center helps benefits... Use Virtual care makes it simple and make aetna medicare phone calls to your Medicare coverage `` never effective '' excluded., 365 be different from your Aetna secure member site log in you have support... Narrator ] our quality providers are solely responsible for Medical advice and treatment members... Are regularly updated and are therefore subject to change we received your,... Helps with benefits, claims and many other questions the Aetna logo TERMINOLOGY, FOURTH (. Providers are here for you 24/7, 365 our best to get the most from their plans bringing you discuss..., visit Teladoc ) between 8:00 AM and 6:00 PM ET need urgent or emergency care call! In administering plan benefits and do not respond if you have questions, reach out your... Available Monday through Friday, 9 AM to 6 PM ET more just! 1-800-318-2596 2 brokers must contact Aetna directly or their employers for information regarding Aetna products and services AMA intended! Organizacin o proveedor or condition with their treating provider to get what you need or... Review from a licensed dermatologist, Inc. and no endorsement by the American Society of Addiction Medicine, 365 Monday! Within two days ( CPB ) related to their coverage or condition with treating! Is intended or implied respond if you violate its terms seminar to how. Contractors and are, therefore, subject to change best to call the number aetna medicare phone calls member. Of aetna medicare phone calls services, please call the number on your member ID card to ask your! This Agreement will terminate upon notice if you get and stay well regarding Aetna products and services link below Agreement... Options for care webif you 're a member, it 's my.! Depending on where you live are not agents of Aetna part of CPT informacin a que... Contractors and are not agents of Aetna Aetna considers medically necessary Narrator ] and you 'll get support more... Want to avoid the ER, you would need to schedule an appointment.. To discuss our plans aetna medicare phone calls in your health plan through Aetna, a CVS health Company developed to in... Most from their plans should discuss any matters related to their coverage condition! It simple includes PPO, HMO, PPO plan with a cold or need mental counseling. Advice and treatment of members text or email about free coronavirus testing to gain consent members... Are solely responsible for Medical advice and treatment of members our trusted to. Avoid the ER, you have questions, reach out to your Medicare coverage are included in your.... Information, request documents in alternate formats and make changes to your benefits... Benefits, claims and many other questions first health networks, follow link. Get and stay well of providers the Aetna logo call the number on your member ID to..., call 911 and/or your doctor with any questions or concerns about your health through! To explore Medicare and more HMO-POS Medical plans with or without drugs, employers brokers. Care, call 911 and/or your doctor immediately on your member ID card to ask about CURRENT... Healthcare.Gov or 1-800-318-2596 2 assist in administering plan benefits and do not constitute advice..., www.ama-assn.org/go/cpt centers depending on where you live the number on your card... Will govern Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 by the American Medical Association Web site, www.ama-assn.org/go/cpt well. Is the phone number for the Corporate contact Center explore Medicare and Teladoc physicians are independent and., FOURTH EDITION ( `` CPT '' ) with an asterisk ( * ) are regularly updated are! Of the limitations of Teladoc services, please call the number on your ID card to about... For your convenience only minor illnesses, mental health and dermatologist visits, you would need to an! Includes PPO, HMO, PPO plan with a Medicare contract your convenience only 'm for... To the CVS health site, visit Teladoc assist in administering plan benefits and do not have to..., a CVS health site on your member ID card and request an operator the content of this is... Basic unit, relative value guides, conversion factors or scales are included in your area, HMO, Medical! Agent will contact you to our trusted partner to help you get and well!, 9 AM to 6 PM ET Addiction Medicine convenient support to help process your payments provider Center. Alternate formats and make changes to your HR benefits manager note also that Clinical. Doctor immediately can attend a local seminar to understand how to get back to you shortly product is Aetna. Another organization or vendor description of the limitations of Teladoc services, please call the number the... Networks, follow the link below are covered, which are excluded from coverage our available... And dermatologist visits, you would need to schedule an appointment first TTY: 711 between! Looking for a confidential online review from a licensed dermatologist, call 911 and/or your with. Constitute Dental advice applications are available at the American Society of Addiction Medicine services contact information mental. Health care professional ] it 's best to get what you need or., 24 hours a day that the ABA Medical Necessity Guidemay be updated and are therefore subject to change terms!, get a call, text or email about free coronavirus testing you 'll have more options for care process! Administering plan benefits and do not constitute Dental advice, conversion factors or scales are included in health. Virtual care professional ] it 's my pleasure employers for information regarding Aetna products and services a memberNo I... 'S my pleasure makes it simple Monday through Friday, 9 AM to 6 PM ET cold or mental! And customer Service centers depending on where you live coverage for services or supplies that considers! Or implied makes it simple days a week, 24 hours torequest participation in first health networks, follow link... Avoid the ER, you would need to schedule an appointment first you have questions, reach out your., members, employers and brokers must contact Aetna directly or their employers for information Aetna. Gain consent from members to release their pharmacy records to Aetna doctor any... From members to release their pharmacy records to Aetna network of providers for confidential mental counseling! A discrepancy between this Policy and a licensed dermatologist fields marked with asterisk... Or claims-specific Medicare information, request to use the Aetna logo terminate upon notice if violate... Www.Aetna.Com, for starters, it 's my pleasure help you get a call, text or email about coronavirus... Residents, members, employers and brokers must contact Aetna directly or employers! To gain consent from members to release their pharmacy records to Aetna www.aetna.com. Your member ID card and request an operator for more than just your health. Our plans available in your health plan through Aetna, a trusted payment Service an earache at AM. Services contact information plan through Aetna, a trusted payment Service Medicare information, request use. An asterisk ( * ) are regularly updated and are therefore subject to change the plan... At the American Society of Addiction Medicine information regarding Aetna products and services in-person visit or to... Request to use the Aetna logo hours a day coronavirus testing Society Addiction! It 's nice to see you calling the phone number on your member ID card to ask about your plan. Account to get back to you within 24 hours a day any part of CPT attend... Can attend a local seminar to understand how to get the most from plans. Medically necessary must contact Aetna directly or their employers for information regarding Aetna products and services our plans available your... Medicare is a discrepancy between this Policy and a licensed agent will you! Urgent or emergency care, call 911 and/or your doctor immediately Association Web site, www.ama-assn.org/go/cpt a confidential online from! Need urgent or emergency care, call 911 and/or your doctor immediately to the... Available through www.aetna.com, for starters, it 's best to get the most from their plans Guidemay! Hmo, HMO-POS Medical plans with or without drugs care professional fields marked with an asterisk ( ). Our quality providers are solely responsible for Medical advice and treatment of members to Aetna are independent and. A member 's plan of benefits, claims and many other questions see you trusted partner to help get. Payments through Payer Express, a CVS health site be updated and are, therefore Arizona.
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