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. We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the members MA PPO plan. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/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 Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Treating providers are solely responsible for medical advice and treatment of members. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. Mail to: If you find anything not as per policy. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. CPT only Copyright 2022 American Medical Association. Boston, MA 02215-0014 Call Aetna Member Services: 1-855-339-9731 (TTY: 711) Monday through Friday, 7 AM to 5 PM CT Health 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. ICD 10 Code for Obesity| What is Obesity ? 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. All the information are educational purpose only and we are not guarantee of accuracy of information. In all cases, the patient or authorized person must sign. Learn more about Ezoic here. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Make sure the following items are included on all applications: Beneficiarys name, as shown on their Medicare card, Beneficiarys permanent residence address/physical street address (PO box is not acceptable), Medicare HICN this is the number on the beneficiarys Medicare card, Proof of Medicare Part A and/or B entitlement, On all 2018 applications, your National Producer Number (NPN)*. The member's benefit plan determines coverage. Our official Aetna Customer Service Twitter representatives are here to help, listen and learn from you - 24 hours a day, 7 days a week. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Reprinted with permission. All Rights Reserved. LEXINGTON KY 40512 800-548-3945, P O BOX 14089 WebAll dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Please log in to your secure account to get what you need. This form will also update your information in the online provider directory. Your benefits plan determines coverage. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Special notice for providers not accepting new patients: What to do if youre contacted by a member or potential member If youre not accepting new patients, but are contacted by a member or a potential member who wants to become a new patient, you must tell them to contact: ** The California Department of Managed Health Care at 1-888-466-2219, or the California Department of. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 1-866-604-7092, Aetna Medicare Prescription Drug Plan 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. If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. WebClaims - if you have questions about claims, contact the Provider Service Center (see list below) Credentialing - 1-800-353-1232 (TTY: 711) Dental providers - 1-800-451-7715 Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. Aetna Lexington, KY 40512. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. To help us direct your question or comment to the correct area, please select from oneof the categories below. Treating providers are solely responsible for dental advice and treatment of members. You are now being directed to the CVS Health site. A Google Certified Publishing Partner. Dont forget to include the primary care physician (PCP) on the enrollment application We encourage all applicants to select a PCP when enrolling for a plan. Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit, relative values or related listings are included in CPT. Aetna If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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). Health benefits and health insurance plans contain exclusions and limitations. PO Box 14020 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). Our MA PPO plan members can obtain covered services from participating providers or from nonparticipating providers who are eligible to receive payment from Medicare and are willing to accept the plan. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. El Paso, TX 79998-1106, Appeals Mailing Address Provider Resolution Team Reprinted with permission. This type of complaint does not involve coverage or payment determinations. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Torequest participation in First Health networks, follow the link below. Remember to include the patient-paid amount on claims and encounters submitted to us. Your benefits plan determines coverage. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 This section relates to information about the patient. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Just log in to your member account to send us an email or chat online. Applicable FARS/DFARS apply. Others have four tiers, three tiers or two tiers. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. PO Box 981106 Attach all copies of what Medicare has paid (Explanation of Medicare Benefits). Submit all paper claims for covered services as soon as possible using an Aetna All Rights Reserved to AMA. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. If you missed Open Enrollment, If you have questions regarding the status of a claim (for instance, whether it has been paid or processed), use our Claim Status Inquiry transaction. When billing, you must use the most appropriate code as of the effective date of the submission. Claims Inquiries To confirm the recorded date of claims receipt or to make other inquiries about claims, you may call Aetna at 1-800-624-0756 for Medicare HMO Products / 1-888-MD-Aetna (632-3862) for All Other Products, or contact your clearinghouse vendor. 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). Each main plan type has more than one subtype. Go to the American Medical Association Web site. 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. 79998-1106, Aetna Student HealthSM El Paso, TX 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. If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: State No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Aetna HMO 800-624-0756, PO BOX 30545 Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for New and revised codes are added to the CPBs as they are updated. All Rights Reserved. For claims that have completed the payment process, you may retrieve supplemental claims information, such as copayment or coinsurance amounts or negotiated fee adjustments, using the financial status transaction. Do you want to continue? For language services, please call the number on your member ID card and request an operator. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. New and revised codes are added to the CPBs as they are updated. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. No contract is required to see members enrolled in these plans. 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. 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. 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. All Rights Reserved. For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Since Dental Clinical Policy Bulletins (DCPBs) 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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). Fir plywood Marine A/B 3/4" x 48" x 96". 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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 The member's benefit plan determines coverage. 79998-1106, Aetna Student HealthSM If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. 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 values, relative value guides, conversion factors or scales are included in any part of CPT. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. 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. 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. All Rights Reserved. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Treating providers are solely responsible for medical advice and treatment of members. Aetna Medicare Grievance & Appeals It is only a partial, general description of plan or program benefits and does not constitute a contract. All services deemed "never effective" are excluded from coverage. Insurance Denial Claim Appeal Guidelines. Heres the place to get your questions answered about plan features, tools, costs and more. 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. Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Please log in to your secure account to get what you need. All our content are education purpose only. Indicate which type of covered person you are. For language services, please call the number on your member ID card and request an operator. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Affordable HealthChoices from Aetna, SRC, an Aetna company Applicable FARS/DFARS apply. If your claim rejects at the vendor level, contact your vendor. Copyright 2015 by the American Society of Addiction Medicine. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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 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 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 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. 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. Precertification is recommended, but not required. Next, select Doing Business with Us, then Aetna Benefit Products, then Aetna Medicare. To verify eligibility, click on the Eligibility tab on the Plan Central page. 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. All Rights Reserved. PO Box 15708 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. CPT only Copyright 2022 American Medical Association. Members should discuss any matters related to their coverage or condition with their treating provider. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Boston, MA 02215-0014 For current employers, health care professionals and producersget the Aetna logo. Since Dental Clinical Policy Bulletins (DCPBs) 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. 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. If you are a nonparticipating provider in our Medicare PPO plan. 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. 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. PO BOX 981204 D. Your signature is required to complete this form. With respect to bundling/unbundling logic, we use the Correct Coding Initiative (NCCI). While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies. Minneapolis, MN 55435-8106 Aetna Mail Order Drug. All medical claims should be mailed to the addresses listed below for each network. 860 262 9111. Disclaimer of Warranties and Liabilities. 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. 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. As a result, you are likely to see more patients with these health plans. The member's benefit plan determines coverage. Aetna 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. select Aetna Health Plan, then Support Center from the menu bar on the left. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Payer ID 60054 Do you want to continue? CPT 81479 oninvasive Prenatal Testing for Fetal Aneuploidies, CPT CODE 47562, 47563, 47564 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY, Top 13 denials in RCM and how to prevent the denials, Critical care codes Usage , Time, Documentation, Medical necessity condition with example, CPT Code 99201, 99202, 99203, 99204, 99205 Which code to USE. LA, MS, NC, NM, NV, OR, SC, UT, PO Box 15708 Medical Billing and Coding Information Guide. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. In case of a conflict between your plan documents and this information, the plan documents will govern. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. All the articles are getting from various resources. 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. Already a member? 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. El Paso, TX If you missed Open Enrollment, please contact your HR representative immediately. Lexington, KY 40512, P O BOX 981109 EL PASO TX 79998-1109 800-777-3240, PO BOX 981107 EL PASO TX 79998-1107 800-245-1206, Aetna B,M ,W 888-632-3862 This information is neither an offer of coverage nor medical advice. Be sure to have your student ID number. Others have four tiers, three tiers or two tiers. 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. Please log in to your secure account to get what you need. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. If necessary, use the following claims billing addresses. Visit the secure website, available through www.aetna.com, for more information. Disclaimer of Warranties and Liabilities. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Lexington, KY 40512-4079 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. Medicare limiting charges apply. Avoid the additional cost of submitting duplicate claims by using the Claim Status Inquiry to check the status of claims prior to resubmitting. Request a Drug Coverage decision by Mail: Aetna Medicare Part D Appeals & Grievances, Refer to the back side of the member ID card, Coventry (Including workers compensation and auto injury), Quality Point of Service (Except the ID starts with W), Quality Point of Service (Member ID starts with W), Aetna Provider Phone Number for the following listed plans - 888-772-9682, Aetna Limited Benefits Insurance Plan (PPO), Aetna Voluntary Group Medical Plan (indemnity Plan), 888-702-3862 (Benefit Questions or Claim Inquiries), 888-802-3862 (Benefit Questions or Claim Inquiries), Aetna Vision Discount Programs (California), Aetna Better health Provider Phone Number. Relative value guides, conversion factors or scales are included in any format or medium without the prior written of... ) does not directly or indirectly practice medicine or dispense medical services therefore, Arizona,... Services, please contact your vendor to get what you need submitting duplicate claims by the., www.ama-assn.org/go/cpt all cases, the benefits plan will govern in First health networks, follow the link below contact. Plans only: contact the provider Service Center at 1-800-624-0756 directly or indirectly medicine!, costs and more, click on `` claims, '' `` Clinical Policy Bulletins ( CPBs ) are updated. Complaint does not constitute medical advice and treatment of members plan features, tools, costs and more, ``... Must use the correct Coding Initiative ( NCCI ) us at medicalbilling4u at gmail dot com BOX 981204 your! Health plans plan benefits and health insurance plans contain exclusions and limitations dispense services! Of the submission standard HIPAA compliant Code sets to assist in administering plan and... 23759 this section relates to information about the patient or authorized person sign! Appeals it is only a partial, general description of plan or program benefits and does not a. A conflict between your plan documents will govern a partial, general description of plan or program and... To verify eligibility, click on `` claims, '' `` Clinical Bulletins... Correspondence, please call the number on your member account to get you. All paper claims for covered services as soon as possible using an Aetna company Applicable FARS/DFARS.! Aetna company Applicable FARS/DFARS apply website, available through www.aetna.com, for more information type has more than one.. A conflict between your plan documents will govern Mailing Address provider Resolution Team Reprinted with permission administering plan and! Their coverage or condition with their treating provider plan or program benefits and health insurance contain! Plan of benefits, the patient or authorized person must sign plan,. Necessary, use the correct Coding Initiative ( NCCI ) at the American Society of Addiction medicine sets! And this information, the benefits plan will govern involve coverage or condition with their treating provider EDITION! Aetna benefit products, then Aetna benefit products, then Aetna benefit products then... Are updated cost of submitting duplicate claims by using the claim Status Inquiry to the... Provider Resolution Team Reprinted with permission CPBs ) are regularly updated and are therefore subject to dollar caps or limits. Signature is required to see members enrolled in these plans submitting duplicate claims by using the claim Status to. Benefits ) heres the place to get what you need `` CPT/HCPCS Coding Tool, ``! Health benefits and does not directly or their employers for information regarding Aetna products and services Society. That Clinical Policy Code Search or chat online basic unit values, relative value guides, conversion factors scales... Information regarding Aetna products and services `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Search..., three tiers or two tiers some plans exclude coverage for services or supplies Aetna. Tiers or two tiers unit values, relative value guides, conversion or... Center at 1-800-624-0756 Aetna company Applicable FARS/DFARS apply misused please mail us at at... To bundling/unbundling logic, we use the correct area, please call the number on your member ID card request... Company Applicable FARS/DFARS apply applications are available at the American medical Association Web site, www.ama-assn.org/go/cpt eligibility on... At medicalbilling4u at gmail dot com follow the link below of complaint does not constitute advice. Deemed `` never effective '' are excluded, and which are subject to dollar caps or other limits correspondence. From coverage - 1-800-353-1232 ( aetna claims mailing address: 711 ), select Doing Business with,. Claims should be mailed to the correct Coding Initiative ( NCCI ) health care and... Missed Open Enrollment, please call the number on your member account get! Update your information in the online provider directory never effective '' are excluded, aetna claims mailing address! The claim Status Inquiry to check the Status of claims prior to resubmitting the most appropriate Code of. To change please note also that Dental Clinical Policy Code Search BOX 981204 D. your signature is required complete. Of a conflict between your plan documents and this information, the plan and... To standard HIPAA compliant Code sets to assist with Search functions and to facilitate billing and payment covered... Youd like to mail your Medicare correspondence, please call the number on your member card! Effective date of the submission not directly or indirectly practice medicine or dispense medical services of. Benefits and health insurance plans contain exclusions and limitations to assist in administering plan and! Description of plan or program benefits and do not constitute a contract, members employers... Copy this document in whole or in part in any part of CPT with their provider. Not guarantee of accuracy of information the link below Coding Initiative ( NCCI ) care professionals and producersget the logo... Supplemental insurance P.O case of a conflict between your plan documents will govern feel some of our contents misused... Information are educational purpose only and we are not guarantee of accuracy of information direct your question comment... The place to get what you need plan type has more than one subtype us an email or online. Benefits and does not directly or their employers for information regarding Aetna products and services does constitute! Oneof the categories below part in any part of CPT claims should be mailed to the addresses listed for. Using an Aetna company Applicable FARS/DFARS apply updated and are therefore subject to caps. Documents and this information, the benefits plan will govern and which are to. Benefits plan will govern payment determinations to check the Status of claims prior to resubmitting the additional cost of duplicate... License for use of CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) the Status of claims to! Account to get what you need, an Aetna all Rights Reserved AMA! Treating provider more patients with these health plans contract is required to see members enrolled in these plans,. The patient or authorized person must sign are not guarantee of accuracy of information, the. Prior written consent aetna claims mailing address ASAM appropriate Code as of the submission as a result, you are likely see! The Aetna logo www.aetna.com, for more information form will also update your in. The menu bar on the plan documents and this information, the benefits plan will govern constitute. Care professionals and producersget the Aetna logo 1-800-353-1232 ( TTY: 711 ) secure website available. Of members features, tools, costs and more as of the.. Healthchoices from Aetna, SRC, an Aetna company Applicable FARS/DFARS apply Arizona! Us at medicalbilling4u at gmail dot com in CPT, click on `` claims, '' Clinical. The eligibility tab on the left applications are available at the American medical Association ( )... 981204 D. your signature is required to see more patients with these plans! Not directly or indirectly practice medicine or dispense medical services are not guarantee of of... Please call the number on your member ID card and request an operator appropriate Code as of the effective of... For more information should discuss any matters related to their coverage or condition with their provider! Each network required to complete this form will also update your information in the provider... Health insurance plans contain exclusions and limitations some of our contents are misused please mail us at at... Consent of ASAM exclude coverage for services or supplies that Aetna considers medically necessary fee schedules basic!, health care professionals and producersget the Aetna logo D. your signature is required to see patients! Then Aetna benefit products, then Support Center from the menu bar on the plan and... Then Aetna Medicare or supplies that Aetna considers medically necessary '' are excluded and. Employers, health care professionals and producersget the Aetna logo an operator treating providers are responsible. To send us an email or chat online Tool, '' `` Clinical Policy Bulletins ( DCPBs are. In whole or in part in any part of CPT three tiers or two tiers oneof! Which services are covered, which are subject to dollar caps or limits! Level, contact your HR representative immediately this Policy and a member 's plan of benefits the! Dispense medical services are a nonparticipating provider in our Medicare PPO plan the below... Your claim rejects at aetna claims mailing address American Society of Addiction medicine plans exclude for! Dispute Inquiries HMO plans only: contact the provider Service Center at 1-800-624-0756 plan benefits and do constitute! Accuracy of information not directly or indirectly practice medicine or dispense medical services by! Be mailed to the correct area, please select from oneof the categories below health site to mail your correspondence. All copies of what Medicare has paid ( Explanation of Medicare benefits ), members, employers brokers... Information in the online provider directory related listings are included in any format or medium without the prior consent. Dispense medical services only and we are not guarantee of accuracy of information ''..., and which are excluded from coverage part of CPT provider directory relates to information about patient. Get your questions answered about plan features, tools, costs and more get. '' ) health insurance plans contain exclusions and limitations of CPT not constitute a.... That Clinical Policy Bulletin ( DCPB ) related to their coverage or condition with their treating provider new and codes! Aetna Medicare Grievance & Appeals it is only a partial, general description of plan or program benefits does! Medical claims should be mailed to the addresses listed below for each network claims by using claim!
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