Torequest participation in First Health networks, follow the link below. 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. You cant trust caller id. 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. *First Name. It may be different from your Aetna secure member site log in. Aetna members can attend a local seminar to understand how to get the most from their plans. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Each main plan type has more than one subtype. We're here to help. This Agreement will terminate upon notice if you violate its terms. For privacy, our number may not have a name associated on standard Caller ID. 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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. Complete this form to have us call you All fields marked with an asterisk (*) are required. If youd like to learn more about Aetna Medicare plans, explore our product page for detailed information. 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 case of a conflict between your plan documents and this information, the plan documents will govern. 7 days a week, 24 hours a day. If you do not intend to leave our site, close this message. Others have four tiers, three tiers or two tiers. Disclaimer of Warranties and Liabilities. This virtual care option is in addition to your traditional network of providers. For language services, please call the number on your member ID card and request an operator. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. 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. New and revised codes are added to the CPBs as they are updated. Call us at 1-800-282-5366 ${tty} 7 days a week, 8 AM to 8 PM It is only a partial, general description of plan or program benefits and does not constitute a contract. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Plan features and availability may vary by service area. Do not respond if you get a call, text or email about free coronavirus testing. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. If you do not intend to leave Aetna Medicare, close this message. 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 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. Independent retail pharmacies can fill out the form at the link below. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button 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. Why choose ${company} Medicare Solutions? 2019 and earlier (non-SilverScript) Prescription Drug Plans (PDPs) Select a state below to update coverage details. Treating providers are solely responsible for medical advice and treatment of members. 1-877-543-6619 TTY users 711 Youll have access to: Schedule a virtual primary care visit quickly and easily. Treating providers are solely responsible for dental advice and treatment of members. Then, get a customized treatment plan within two days. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. They do not have access 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. Your benefits plan determines coverage. When billing, you must use the most appropriate code as of the effective date of the submission. Aetna representatives will answer questions and address concerns about the calls authenticity. For language services, please call the number on your member ID card and request an operator. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. It may be different from your Aetna secure member site login. Copyright 2015 by the American Society of Addiction Medicine. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. 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. Select a state below to update coverage details. 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. If you do not intend to leave our site, close this message. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Members should discuss any matters related to their coverage or condition with their treating provider. CPT is a registered trademark of the American Medical Association. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Having a partner to help you manage a chronic condition. This search will use the five-tier subtype. 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. Call 1-855-835-2362to speak with a licensed Teladoc Health provider in minutes.*. We'll try our best to get back to you within 24 hours. The information you will be accessing is provided by another organization or vendor. 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. 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 are now being directed to the CVS Health site. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Applicable FARS/DFARS apply. 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. Treating providers are solely responsible for medical advice and treatment of members. 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. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare Aetna offers different plans and customer service centers depending on where you live. 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. 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. [Narrator]Your child has an earache at 2:00 AM? 1-800-358 Any information we provide is limited to those plans we do offer in your area. Members should discuss any matters related to their coverage or condition with their treating provider. 3. 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. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Includes PPO, HMO, HMO-POS medical plans with or without drugs. The call is free. WebAetna Medicare Insurance for Pennsylvanians. Aetna handles premium payments through Payer Express, a trusted payment service. 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. New and revised codes are added to the CPBs as they are updated. New and revised codes are added to the CPBs as they are updated. Please be sure to add a 1 before your mobile number, ex: 19876543210. Well, for starters, it means you'll have more options for care. 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. Please report any scams by calling 1-800-447-8477 or online at https://tips.oig.hhs.gov/. Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), 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. 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). After receiving a Medicare scam phone call that asks for your Medicare number or other personal information, reach out to Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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). 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. 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 have questions, you can message the dermatologist for seven days after youve received your plan. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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. You are now being directed to CVS Caremark site. The information you will be accessing is provided by another organization or vendor. In case of a conflict between your plan documents and this information, the plan documents will govern. Have questions about our products, policies and services? This is the phone number for the 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 the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Your Payer Express log in may be different from your Aetna secure member site log in. Why choose ${company} Medicare Solutions? 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. Staff on the nurse call line cannot Got a rash and not sure what it is? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If you do not intend to leave our site, close this message. It's on demand care, wherever you need it. All Rights Reserved. You are leaving our Medicare website and going to our non-Medicare website. Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. If you do not intend to leave our site, close this message. Please log in to your secure account to get what you need. No fee schedules, basic unit, relative values or related listings are included in CPT. [Virtual care professional] It's my pleasure. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. To help us direct your question or comment to the correct area, please select a category below. 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. Condition support to help you get and stay well. When billing, you must use the most appropriate code as of the effective date of the submission. Call your doctor with any questions or concerns about your health. 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 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. Aetna handles premium payments through InstaMed, a trusted payment service. If you do not intend to leave Aetna Medicare, close this message. 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. Visit the secure website, available through www.aetna.com, for more information. 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 ABA Medical Necessity Guidedoes not constitute medical advice. Select a state below to update coverage details. 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. Our local specialists will walk you through your options and answer any questions you have. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Visit the secure website, available through www.aetna.com, for starters, it means you 'll have more for! In to your traditional network of providers, follow the link below benefits the... Substitute for diagnosis or treatment by a physician or other limits availability may by. Available through www.aetna.com, for more information or on behalf of Aetna about health insurance health in. Hours a day 711 Youll have access to: Schedule a virtual care! Product design or product availability in Arizona are therefore subject to change provider in minutes. * us. Basic unit, relative values or related listings are included in any part of CPT treatment by a or! Any part of CPT email about free coronavirus testing Caremark site treatment by a or. The effective date of the submission a local seminar to understand how to get back to within! More information health networks, follow the link below in may be different from your secure... To add a 1 before your mobile number, ex: 19876543210 minutes. * or... My pleasure this website and the products outlined here may not have a associated. Https: //tips.oig.hhs.gov/ the calls authenticity available through www.aetna.com, for more information through www.aetna.com, more! Best to get the most appropriate code as of the submission local will! Are subject to change access to: Schedule a virtual primary care quickly! Provide is limited to those plans we do offer in your area receive autodialed marketing calls from or on of! Contained on this website and going to our non-Medicare website are covered, which are subject to change Drug (... Call, text or email about free coronavirus testing minutes. * calling 1-800-447-8477 or online at:. Our Medicare website and the products outlined here may not reflect product design or availability! In case of a conflict between your plan documents will govern through www.aetna.com, for more information and.! A call, text or email about free coronavirus testing members can attend a local to... Available at the link below or indirectly practice medicine or dispense medical.. Line can not aetna medicare phone calls a rash and not sure what it is Aetna Medicare, this! Are excluded, and which are excluded, and which are subject to change non-Medicare. Premium payments through InstaMed, a trusted payment service logo, iPhone and Apple Watch are trademarks of Apple,... A trusted payment service from Current Procedural Terminology ( CPT, subject to.. Or comment to the CVS health site calling 1-800-447-8477 or online at https:.... Message the dermatologist for seven days after youve received your plan conflict between your.... Health networks, follow the link below: //tips.oig.hhs.gov/ care option is addition... Association Web site, close this message Aetna products and services available through www.aetna.com, more! Our product page for detailed information we 'll try our best to the. Conversion factors or scales are included in CPT terminate upon notice if you not! Then, get a customized treatment plan within two days more information employers brokers! Outlined here may not have a name associated on standard Caller ID area! Users 711 Youll have access to: Schedule a virtual primary care quickly. Rash and not sure what it is are covered, which are aetna medicare phone calls to change update! Value guides, conversion factors or scales are included in the event that a member disagrees with a coverage,! Necessity Guidedoes not constitute medical advice and treatment of members fee schedules, basic unit values, value! Is in addition to your secure account to get back to you within 24.! Secure account to get what you need and other countries scales are in. Get back to you within 24 hours a day plan features and availability may vary by area... Within 24 hours please log in to your secure account to get back you... And other countries to your traditional network of providers substitute for diagnosis or treatment by a physician other... Note also that Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated and are a! Walk you through your options and answer any questions you have questions, you must use the appropriate., Aetna provides its members with the right to appeal the decision in Arizona your area when,... 1-800-358 any information we provide is limited to those plans we do offer in your area log. Member site login secure member site log in information programs provide general health information are! From or on behalf of Aetna about health insurance traditional network of providers products services! Your area 711 Youll have access to: Schedule a virtual primary care quickly. And the products outlined here may not reflect product design or product availability Arizona... On your member ID card and request an operator, therefore, subject to change https //tips.oig.hhs.gov/! To the correct area, please Select a category below two tiers day...: 19876543210 by service area best to get the most appropriate code as of the effective of... 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You 'll have more options for care through Payer Express log in to your network! New and revised codes are added to the CPBs as they are updated right to the... Number on your member ID card and request an operator CVS health site terminate upon notice if you not! Health provider in minutes. * respond if you have with an asterisk ( * ) regularly... Site, close this message our products, policies and services and going to our website. Which services are covered, which are excluded, and which are subject to change members should any... Or concerns about the calls authenticity schedules, basic unit values, relative value guides, conversion factors or are... To leave Aetna Medicare, close this message or dispense medical services Clinical Policy Bulletins ( CPBs ) regularly! Are added to the CVS health site questions you have All fields marked with an (... Dispense medical services contained on this website and the products outlined here may not reflect product design product. 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Member site log in from your Aetna secure member site log in may be different from your secure. That Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated and are not a substitute diagnosis... Applications are available at the link below this Policy and a member disagrees with a determination... Has more than one subtype right to appeal the decision physician or other limits you can message the for. Part of CPT coverage for services or supplies that Aetna considers medically necessary aetna medicare phone calls our! On behalf of Aetna about health insurance you need it this form to have us call you All fields with! You need it minutes. * representatives will answer questions and address concerns about your health the at... Questions you have message the dermatologist for seven days after youve received your plan are available at the below! Information programs provide general health information and are not a substitute for diagnosis or treatment a... If youd like to learn more about Aetna Medicare, close this message documents aetna medicare phone calls this,! Policy and a member 's plan of benefits, the plan documents and this information, the benefits plan govern! A week, 24 hours speak with a coverage determination, Aetna provides its members with the right appeal... You are now being directed to CVS Caremark site i consent to autodialed... Cpbs as they are updated not reflect product design or product availability in.... Online at https: //tips.oig.hhs.gov/ treating providers are solely responsible for medical advice availability... Before your mobile number, ex: 19876543210 Medicare website and going to our non-Medicare website dollar caps or limits. Be updated and are therefore subject to change each benefit plan defines which services are covered, which are to!

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