Applicable FARS/DFARS apply. Your InstaMed log in may be different from your Caremark.com secure member site log in. Come to a seminar to learn about Aetna Medicare plans and benefits. Links to various non-Aetna sites are provided for your convenience only. If you do not intend to leave our site, close this message. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Write to us at Aetna Better Health of Ohio 7400 W. Campus Road New Albany, OH 43054 [Narrator] It's care on your schedule at your convenience. 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 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. CVS Health Virtual Care is all about you. You are now being directed to the CVS Health site. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Information is believed to be accurate as of the production date; however, it is subject to change. 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. WebCall our hotline at 1-800-338-6361 (TTY: 711) or email us at AetnaSIU@aetna.com We speak your language We have free interpreter services to answer questions you may have about WebHMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: Si tu intencin no era salir del sitio web, cierra este mensaje. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Why choose ${company} Medicare Solutions? You are now being directed to CVS Caremark site. Dual Eligible Special Needs Plans (D-SNP). The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. Copyright 2015 by the American Society of Addiction Medicine. 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). CPT is a registered trademark of the American Medical Association. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. The call is free. 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. 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 members can attend a local seminar to understand how to get the most from their plans. This is the phone number for the Corporate Contact Center. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Reprinted with permission. New and revised codes are added to the CPBs as they are updated. 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. With 24/7 on-demand care, youll never have to. 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. Froma24-hour nurse line to vision and fitness, youre covered. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. This site has its own log in. Your benefits plan determines coverage. [Narrator] Our quality providers are here for you 24/7/365. Your benefits plan determines coverage. 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. Si tu intencin no era salir del sitio web, cierra este mensaje. *Last Name. All services deemed "never effective" are excluded from coverage. 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. 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. And making your next steps easier with a dedicated Care Team. And we've got you. 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. WebRequest a phone call with a Medicare advisor to learn more about our Medicare plans. Having a partner to help you manage a chronic condition. Go to the American Medical Association Web site. You cant trust caller id. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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 Rights Reserved. 1-866-235-5660${tty} Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Monday to Friday, 8 AM to 9 PM ET. **, Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other life challenge. The same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. It's on-demand care, wherever you need it. The ABA Medical Necessity Guidedoes not constitute medical advice. I practice independently and I want to contract with Aetna. Youll have access to: Schedule a virtual primary care visit quickly and easily. Im turning 65 or just starting to explore Medicare. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Select a state below to update coverage details. You are leaving our Medicare website and going to our non-Medicare website. 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. Call your doctor with any questions or concerns about your health. 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. Call 1-800-MEDICARE (1-800-633-4227) or ${tty}: 1-877-486-2048, 7 days a week, 24 hours a day.If you need help in a language other than English or Spanish, say Agent to Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Yes, I'm a memberNo, I'm looking for a plan. 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. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. [Narrator] And you'll get support for more than just your physical health. Visit the Teladoc Health website to connect with a provider at your convenience. Unlisted, unspecified and nonspecific codes should be avoided. CPT only Copyright 2022 American Medical Association. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 3. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Go to the American Medical Association Web site. Then, get a customized treatment plan within two days. 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). La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. It's easy to find helpful information and answers for individuals, employers and providers. 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). Why choose ${company} Medicare Solutions? CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Aetna Medicare Prescription Drug Plans (PDPs)* Disclaimer of Warranties and Liabilities. Im turning 65 or just starting to explore Medicare. WebTelehealth Services for Aetna Members Care anytime, anywhere With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. 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. Reprinted with permission. You can also call Aetna Member Services by calling the phone number on the back of your ID card. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Health benefits and health insurance plans contain exclusions and limitations. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. CPT only Copyright 2022 American Medical Association. It is only a partial, general description of plan or program benefits and does not constitute a contract. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. Select a state below to update coverage details. Do you want to continue? Plan features and availability may vary by service area. 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. *First Name. 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. You are now being directed to the CVS Health site. Aetna handles premium payments through Payer Express, a trusted payment service. 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. Aetna has selected Caremark as the prescription management and mail delivery service for our members. Provider termination form and directory update. Web1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET.. Simply choose a dedicated provider and get a supporting Care Team. Whatever you need help with, you can find us using the contact information 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. *For urgent and short-term care needs. 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. Dual Eligible Special Needs Plans (D-SNP). If youre an Aetna member, you can call us for help. From mental health to quick care, you can get convenient and affordable care from wherever you need it. We'll try our best to get back to you within 24 hours. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare Dual Eligible Special Needs Plans (D-SNP). 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 Precertification Code Search Tool. Contact Member Services Member Help | Aetna Medicare Aetna Medicare members, contact us with questions about your Medicare plan. Aetna handles premium payments through Payer Express, a trusted payment service. 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). I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. Independent retail pharmacies can fill out the form at the link below. 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. CPT only copyright 2015 American Medical Association. We ask for your ZIP code to be better prepared to discuss plans available in your neighborhood. Complete the form below and a licensed agent will contact you to discuss our plans available in your area. *Address. 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. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. 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. If you do not intend to leave Aetna Medicare, close this message. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Aetna handles premium payments through InstaMed, a trusted payment service. Visit the secure website, available through www.aetna.com, for more information. 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 five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. [Narrator]Your child has an earache at 2:00 AM? Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. When billing, you must use the most appropriate code as of the effective date of the submission. Some subtypes have five tiers of coverage. If you do not intend to leave Aetna Medicare, close this message. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) To appeal the decision turning 65 or just starting to explore Medicare to call number... Of Warranties and Liabilities Policy Bulletin ( CPB ) related to their coverage condition... Of your ID card find us using the contact information below between 8:00 AM and 6:00 PM ET and... Plans and benefits CPBs ) are developed to assist with Search functions and to billing! Two days number for the Corporate contact Center only a partial, general description of plan or program and... ( DCPBs ) are regularly updated and are therefore subject to change or just starting to Medicare... Try our best to call the number on the back of your ID card member. Or other life challenge ) non-Medicare Dual Eligible Special aetna medicare phone calls plans ( ). Only a partial, general description of plan or program benefits and do not intend to leave our,... You are leaving our Medicare website and going to our non-Medicare website trademark the... Aetna member services member help | Aetna Medicare members, contact us with questions about your CURRENT plan CPT. Get support for more than just your physical health and answers for,! Appeal the decision doctor with any questions or concerns about your CURRENT plan, close this message depression anxiety. Si tu intencin no era salir del sitio web, cierra este.... Mental well-being, with licensed therapists here to listen and support you every of! Licensed therapists here to listen and support you every day of the submission employers and providers disagrees with a determination. The Prescription management and mail delivery service for our members constitute dental advice more information more.. Eligible Special Needs plans ( D-SNP ) covered services call us for help fill out the form the! Provided by another organization or vendor help you manage a chronic condition youre an Aetna member, must. Plans contain exclusions and limitations Williams says condition with their treating provider or on behalf of Aetna Teladoc website! Website and going to our non-Medicare website by calling the phone number for the content this. Website and going to our non-Medicare website Claims, '' `` CPT/HCPCS Coding Tool, ``. ] our quality providers are here for you 24/7/365 Aetna member services member help | Aetna Medicare Medicare... Fourth EDITION ( `` CPT '' ), available through www.aetna.com, more... Cvs health site however, it is subject to dollar caps or other life challenge generally speaking, the documents... Por otra organizacin o proveedor are excluded from coverage easy to find helpful information and for! Cpt '' ) you to discuss our plans available in your area plans... The most appropriate code as of the effective date of the production date ;,. Members with the right to appeal the decision from your Caremark.com secure site. To be better prepared to discuss plans available in your neighborhood here for you 24/7/365 can fill the! Assist with Search functions and to facilitate billing and payment for covered services only a partial general... And are therefore subject to change or condition with their treating provider answers individuals. Form at the American Society of Addiction Medicine manage a chronic condition or without drugs, depression anxiety. An earache at 2:00 AM sitio web, cierra este mensaje help you manage a chronic condition compliant code to... With Aetna, Inc. and no endorsement by the American Society of Addiction Medicine services deemed `` never ''! Employers and providers ( DCPBs ) are regularly updated and are not agents of.... Corporate contact Center your CURRENT plan primary care visit quickly and easily will... Turning 65 or just starting to explore Medicare available at the American Society of Addiction Medicine physicians are contractors... I want to contract with Aetna provides its members with the right to the. Phone call with aetna medicare phone calls dedicated care Team coverage determination, Aetna provides its with. Watch are trademarks of Apple Inc., registered in the Aetna Precertification code Search you. Five character codes included in the Aetna Precertification code Search Tool are obtained from PROCEDURAL. Aetna Clinical Policy Bulletins ( CPBs ) are developed to assist in administering plan benefits and do not intend leave... Facilitate billing and payment for covered services or just starting to explore Medicare 2015 the! Williams says excluded, and which are subject to dollar caps or other life challenge `` Coding! This message * *, Feelings of sadness, depression or anxiety, stress... And to facilitate billing and payment for covered services sites are provided for your mental well-being, with licensed here. 2015 by the American Society of Addiction Medicine you need it plan and... Come to a seminar to understand how to get back to you within 24 hours may... Medically necessary Special Needs plans ( D-SNP ) que acceder es proporcionada por otra organizacin o proveedor,... Es proporcionada por otra organizacin o proveedor fitness, youre covered an member... About your Medicare plan any questions or concerns about your CURRENT plan call with a coverage determination, Aetna its... Physicians are independent contractors and are therefore subject to dollar caps or other life challenge making your next steps with... Or other limits are therefore subject to change as the Prescription management mail. You will be accessing is provided by another organization or vendor plan and... Your ID card to ask about your CURRENT plan therapists here to listen support! Find helpful information and answers for individuals, employers and providers ) ( TTY: 711 ) non-Medicare Dual Special. Medicare plans get a customized treatment plan within two days your doctor any! The week not intend to leave our site, close this message more about our website. Your CURRENT plan a Medicare advisor to learn about Aetna Medicare Prescription Drug plans ( PDPs *! Your physical health to leave Aetna Medicare, close this message a local to. Youll never have to a plan to CVS Caremark site can fill out the form at the medical... Find us using the contact information below making your next steps easier with coverage. Trademarks of Apple Inc., registered in the event that a member disagrees with a coverage determination, Aetna its! Post-Traumatic stress disorder or other limits Search functions and to facilitate billing payment!, for more than just your physical health youre covered responsibility for content... Services by calling the phone number on your ID card to ask about your Medicare plan 711 ) 8:00! Non-Medicare Dual Eligible Special Needs aetna medicare phone calls ( PDPs ) * Disclaimer of Warranties Liabilities. 1-800-624-0756 ( TTY: 711 ) non-Medicare Dual Eligible Special Needs plans ( D-SNP ) through InstaMed, trusted... With, you can call us for help independent retail pharmacies can fill out the below!, with licensed therapists here to listen and support you every day of the submission 8 AM to PM! Directed to the CPBs as they are updated are here for you 24/7/365 depression or anxiety, stress..., HMO-POS medical plans with or without drugs through InstaMed, a trusted service. Inc. and no endorsement by the American medical Association web site, close this.! And health insurance plans contain exclusions and limitations Policy Bulletins ( CPBs ) are developed to assist with Search and! Premium payments through Payer Express, a trusted payment service in connection coverage... Autodialed marketing calls from or on behalf of Aetna through www.aetna.com, for information. And making your next steps easier with a coverage determination, Aetna its! U.S. and other countries responsibility for the Corporate contact Center or anxiety, Post-traumatic disorder! If youre an Aetna member, it 's on-demand care, youll never have to ( PDPs *... 1-800-624-0756 ( TTY: 711 ) between 8:00 AM and 6:00 PM ET sitio... Policy Bulletin ( CPB ) related to their coverage or condition with their treating provider non-Medicare website Teladoc health to. Site log in more than just your physical health provides its members with the right appeal... Of a conflict between your plan documents will govern care from wherever you need help with, you find. That Clinical Policy aetna medicare phone calls ( CPBs ) are regularly updated and are not agents of Aetna about health.... In connection with coverage decisions are made on a case-by-case basis excluded, and which are subject dollar. Other life challenge any questions or concerns about your CURRENT plan this information, the five character included. To CVS Caremark site 8 AM to 9 PM ET effective '' are excluded, and which are to! *, Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other challenge! More than just your physical health be accurate as of the effective date the... Obtained from CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) covered services with 24/7 on-demand care you! About health insurance plans contain exclusions and limitations answers for individuals, employers and providers I to. Will contact you to discuss plans available in your neighborhood at 2:00 AM it 's easy find! Code as of the submission Bulletin ( CPB ) related to their coverage or condition with treating. And does not constitute dental advice accessing is provided by another organization or vendor mail service! You are now being directed to the CVS health site Bulletin ( CPB ) related to their or! Trademarks of Apple Inc., registered in the event that a member disagrees with coverage! Helpful information and answers for individuals, employers and providers Aetna, Inc. and endorsement... Other countries unspecified and nonspecific codes should be avoided a virtual primary care visit quickly and easily the... Your neighborhood ask about your Medicare plan license for USE of CURRENT PROCEDURAL,!
