Were bringing you to our trusted partner to help process your payments. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Others have four tiers, three tiers or two tiers. Let us help! From mental health to quick care, you can get convenient and affordable care from wherever you need it. You cant trust caller id. 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. 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. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The ABA Medical Necessity Guidedoes not constitute medical advice. 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. 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. *For urgent and short-term care needs. Aetna offers different plans and customer service centers depending on where you live. Some subtypes have five tiers of coverage. Have questions or need to connect with us? The AMA is a third party beneficiary to this Agreement. Treating providers are solely responsible for medical advice and treatment of members. 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. 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. 3. For a complete description of the limitations of Teladoc services, visit Teladoc. Staff on the nurse call line cannot diagnose, prescribe or give medical advice. If you do not intend to leave Aetna Medicare, close this message. 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. To view the form just select Continue. 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. 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: 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. 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. Want to see options for a different location? Aetna handles premium payments through Payer Express, a trusted payment service. All Rights Reserved. Do not give out your Aetna member ID number or other personal information. You can use virtual care in addition to your traditional network of providers. The member's benefit plan determines coverage. Others have four tiers, three tiers or two tiers. Call 1-855-835-2362to speak with a licensed Teladoc Health provider in minutes.*. 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. Yes, I'm a memberNo, I'm looking for a plan. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Convenient and affordable care wherever you need it. Youll have access to: Schedule a virtual primary care visit quickly and easily. 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. [Narrator] Our quality providers are here for you 24/7/365. WebUSA. 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. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. 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). Any information we provide is limited to those plans we do offer in your area. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). The information you will be accessing is provided by another organization or vendor. With 24/7 on-demand care, youll never have to. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. WebWe do not offer every plan available in your area. Choose your state, county and plan below to find the phone number for your plan. The Provider Service Center helps with benefits, claims and many other questions. 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. 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). 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. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. You are now being directed to CVS Caremark site. [Narrator] Our quality providers are here for you 24/7, 365. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Go to the American Medical Association Web site. 7 days a week,24 hours a day, Address: Member Services and DSNP Customer Service, Pennsylvania Institutional Special Needs Plan (PA I-SNP), Address: Aetna Duals COE Member Correspondence. We've got your back. 7 days a week, 24 hours a day. You are leaving our Medicare website and going to our non-Medicare website. Want to see options for a different location? Treating providers are solely responsible for dental advice and treatment of members. All Rights Reserved. You are now being directed to CVS Caremark site. *MinuteClinic in-person services are not included with this product and are subject to plan benefit. Some subtypes have five tiers of coverage. CPT is a registered trademark of the American Medical Association. Our local specialists will walk you through your options and answer any questions you have. Disclaimer of Warranties and Liabilities. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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). Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. I may or may not be employed by an Aetna-contracted provider. Scammers say you need to pay a fee for a new Medicare card or youll lose your Medicare coverage. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". [Virtual care professional] It's my pleasure. Youll have access to on-demand care and mental health services from anywhere. If youd like to learn more about Aetna Medicare plans, explore our product page for detailed information. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. And you can extend your care to be seen in-person with an in-network provider or schedule an appointment at your local Minute Clinic, just like that. They do not have access to member accounts but they can provide Aetna Member Services contact information. The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. New and revised codes are added to the CPBs as they are updated. 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. This is the phone number for the Corporate Contact Center. Visit the secure website, available through www.aetna.com, for more information. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Having a partner to help you manage a chronic condition. 1-866-235-5660${tty} 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. 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. CPT only copyright 2015 American Medical Association. 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 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. Im turning 65 or just starting to explore Medicare. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Members should discuss any matters related to their coverage or condition with their treating provider. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Dual Eligible Special Needs Plans (D-SNP). 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. Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. I tell everyone who is having a 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. 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. 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. 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. 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. Got a rash and not sure what it is? Well need to terminate your existing agreement with us. 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. The information you will be accessing is provided by another organization or vendor. Each main plan type has more than one subtype. Froma24-hour nurse line to vision and fitness, youre covered. Aetna Medicare Prescription Drug Plans (PDPs)* Get started with Teladoc Health through the Aetna HealthSMapp. Were bringing you to our trusted partner to help process your payments. Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. 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 CPT only copyright 2015 American Medical Association. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. But you never need to pay for a new card. Aetna handles premium payments through Payer Express, a trusted payment service. For language services, please call the number on your member ID card and request an operator. You can also call Aetna Member Services by calling the phone number on the back of your ID card. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies. All services deemed "never effective" are excluded from coverage. 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 responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Links to various non-Aetna sites are provided for your convenience only. To view the form just select Continue. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. The information you will be accessing is provided by another organization or vendor. 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. The information you will be accessing is provided by another organization or vendor. Aetna members can attend a local seminar to understand how to get the most from their plans. We ask for your phone number so we may call you to schedule an in-person appointment at a time thats convenient for you. Report the call. This site has its own log in. 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". This search will use the five-tier subtype. 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). We're here to help. 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).
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