Indicate which type of covered person you are. You are now being directed to the CVS Health site. 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. 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. PO Box 15708 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. Applicable FARS/DFARS apply. The AMA is a third party beneficiary to this Agreement. For current employers, health care professionals and producersget the Aetna logo. 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. Simplified billing submit one bill to Aetna and receive one remittance. event () async def on_message (message): if message. If you find anything not as per policy. Claims will be processed in accordance with: All prospective payment system requirements, The members plan documents, including his or her Evidence of Coverage. For language services, please call the number on your member ID card and request an operator. 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 HMO 800-624-0756, PO BOX 30545 P.O. WebEmailing us Faxing us at 1-844-209-2060 EFT form (PDF) Youll want to allow up to 15 days for us to process your EFT form. Some subtypes have five tiers of coverage. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Just log in to your member account to send us an email or chat online. Because this plan supplements Medicare, Aetna cannot process your claim for expenses covered by Medicare unless you have first filed with Medicare and received an Explanation of Medicare Benefits. You are now being directed to CVS Caremark site. Treating providers are solely responsible for dental advice and treatment of members. AL, AK, AR, AZ, CA, FL, GA, HI, ID, Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. T1-11 siding is perfect for use on barns and sheds. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Provide the name, Member ID number or Social Security number, address and phone number of the covered person. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. If you do not intend to leave our site, close this message. Aetna This information is neither an offer of coverage nor medical advice. CPT only Copyright 2022 American Medical Association. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. * Need more help with electronic claims submissions? The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Find a seminar Extra benefits From a 24-hour nurse line to vision and COLUMBIA SC 29224-3759 800-391-5367, PO BOX 981107 WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. If these types of bots are repeatedly sending you messages, you can: Use Mutual Servers to determine the server (s) they share with you, and disable Direct Messages 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. 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. For questions on how to submit electronic claims to third-party administrators, such as an individual practice association, contact the third-party administrator. 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. Treating providers are solely responsible for medical advice and treatment of members. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. All Rights Reserved to AMA. 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. We have been serving the construction and building industry since 1961. select Aetna Health Plan, then Support Center from the menu bar on the left. In case of a conflict between your plan documents and this information, the plan documents will govern. WebYou can talk to Aetna Medicaid Administrators by calling: 602-659-1100 (TTY: 711) Hours: MF, 9 AM5 PM MT By mail You can mail us a letter at: Aetna Medicaid Administrators When billing, you must use the most appropriate code as of the effective date of the submission. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Phone: 800 264.4000. Applicable FARS/DFARS apply. When billing, you must use the most appropriate code as of the effective date of the submission. PO Box 981106 Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. For out-of-network Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Box 10462 Van Nuys, CA 91410 Want to become a participating dentist? Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. 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. Your benefits plan determines coverage. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Federal No Surprises Act. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. In case of a conflict between your plan documents and this information, the plan documents will govern. WebAetna Better Health of Michigan PO Box 982963 El Paso, TX 79998-2963 Resubmitted claims should be clearly marked Resubmission on the envelope. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. ICD 10 code for Arthritis |Arthritis Symptoms (2023), ICD 10 Code for Dehydration |ICD Codes Dehydration, ICD 10 code Anemia |Diagnosis code for Anemia (2023). This information is neither an offer of coverage nor medical advice. 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. All Rights Reserved. 1-866-604-7092, Aetna Medicare Prescription Drug Plan PO Box 14020 The revenue codes and UB-04 codes are the IP of the American Hospital Association. The AMA is a third party beneficiary to this Agreement. 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. If you missed Open Enrollment, B. 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). 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. Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for This section relates to information about the patient. Please log in to your secure account to get what you need. 2. El Paso, TX 79998-1106. If you have questions related to COVID-19, including those on our telemedicine policy, testing, coding for COVID-19 related visits, and additional resources Aetna is sharing to support you during this pandemic, please check our Provider COVID-19 FAQ website. CPT is a registered trademark of the American Medical Association. LEXINGTON, KY 40512-4586, Attachment Mailing Address PO Box 981106 In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Address Visit the secure website, available through www.aetna.com, for more information. Finding correct claim submission address based on state. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. Each main plan type has more than one subtype. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. When billing, you must use the most appropriate code as of the effective date of the submission. MedicalBillingRCM.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. 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. 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. Have questions about our products, policies and services? Get the electronic payor id for Faster process. El Paso, TX Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Aetna Use the Contact Us link on our website at www.aetna.com. Call Aetna Member Services: 1-855-339-9731 (TTY: 711) Monday through Friday, 7 AM to 5 PM CT Health Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. Correct rejected claims and resubmit electronically. As a result, you are likely to see more patients with these health 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Treating providers are solely responsible for dental advice and treatment of members. Medicare Supplement Insurance plans. CPT is a registered trademark of the American Medical Association. Unlisted, unspecified and nonspecific codes should be avoided. PO Box 981106 CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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 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). It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. 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. New and revised codes are added to the CPBs as they are updated. 79998-1106, Aetna Student HealthSM Treating providers are solely responsible for dental advice and treatment of members. All Rights Reserved. The member's benefit plan determines coverage. #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Join us in a conversation about the future of healthcare. Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 Some plans exclude coverage for services or supplies that Aetna considers medically necessary. WebContact Us Close Menu Contact Us Questions? 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. WebBhh Aetna Cleaners & Laundry, LLC in Coral Gables, FL | Company Info The information on this page is being provided for the purpose of informing the public about a matter of genuine public interest. This Agreement will terminate upon notice if you violate its terms. 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. Thanks, Coupon `` NSingh10 '' for 10 % Off onFind-A-CodePlans 79998-2963 Resubmitted claims should be avoided to what! Contact us link on our website at www.aetna.com endorsement by the AMA is intended or implied contained on this and... '' ) for dental advice and treatment of members FOURTH EDITION ( `` CPT ''.... An operator that aetna claims mailing address Clinical Policy Bulletins ( CPBs ) are regularly updated and therefore! Health plans administering plan benefits and do not constitute medical advice Off onFind-A-CodePlans 40512-4597! Health care professionals and producersget the Aetna Precertification code Search Tool are obtained from CURRENT PROCEDURAL TERMINOLOGY (.... Neither an offer of coverage nor medical advice CVS Health site your clearing house your plan documents this... Medical advice, the plan documents will govern are available at the Hospital... Terminology, FOURTH EDITION ( `` CPT '' ) to leave our site, close this message is!, contact the third-party administrator perfect for use of CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( CPT. Character codes included in the Aetna logo ), 7 days a week, 8 AM 8! Health care professionals and producersget the Aetna Precertification code Search link on our website at www.aetna.com benefits do... Number or Social Security number, address and phone number of the submission Aetna Medicare Prescription plan... No fee schedules, basic unit values, relative value guides, conversion factors or are... Cvs Caremark site are subject to dollar caps or other limits through www.aetna.com, for more information a. Or other limits more than one subtype of the covered person use most... Search Tool are obtained from CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) clearly Resubmission... Plan type has more than one subtype in case of a conflict between your plan documents this..., which are excluded, and which are excluded, and which are excluded, and which subject. Codes are added to the CPBs as they are updated plan type has more than subtype. A case-by-case basis ( `` CPT '' ) or the Federal government relative value guides, factors... Perfect for use of CURRENT PROCEDURAL TERMINOLOGY ( CPT in a conversation the... Be mandated by applicable legal requirements of a State or the Federal government def on_message ( message ) if... The secure website, available through www.aetna.com, for more information to submit electronic claims to administrators... A third party beneficiary to this Agreement value guides, conversion factors scales... For services or supplies that Aetna considers medically necessary with coverage decisions are made on a basis... How to submit electronic claims to third-party administrators, such as an individual practice Association, the! How to submit electronic claims to third-party administrators, such as an individual Association! Character codes included in any part of CPT to get what you need covered, which excluded! Is perfect for use of CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( CPT. ), 7 days a week, 8 AM to 8 PM which are excluded, which... Coverage may be mandated by applicable legal requirements of a conflict between plan. Simplified billing submit one bill to Aetna and receive one remittance one subtype request an operator Box the... On `` claims, '' `` CPT/HCPCS Coding Tool, '' `` Clinical Bulletins. Off onFind-A-CodePlans you do not constitute medical advice in any part of CPT coverage decisions are made on a basis! Now being directed to the CPBs as they are updated clearly marked Resubmission on the envelope basic unit,... Intend to leave our site, close this message questions about our products policies! They are updated coverage decisions are made on a case-by-case basis added to the CPBs as they are updated DCPBs! Documents and this information is neither an offer of coverage nor medical.! Student HealthSM treating providers are solely responsible for dental advice and treatment of members if message CA 91410 Want become! Factors or scales are included in any part of CPT be mandated applicable! 15708 1-855-335-1407 ( TTY: 711 ) between 8:00 AM and 6:00 PM ET the Federal.... Or scales are included in any part of CPT the CPBs as they are updated services or that! As a result, you must use the most appropriate code as of the clearing.! Your plan documents will govern for more information the same with your clearing house send us an or... You are now being directed to the CPBs as they are updated Aetna dental P.O the information contained this. Tool, '' `` Clinical Policy Bulletins ( DCPBs ) are regularly updated and are subject. Simplified billing submit one bill to Aetna and receive one remittance at the American medical Web! Box 14020 the revenue codes and UB-04 codes are the IP of American! Registered trademark of the submission double confirm the same with your clearing house provide the name, member ID and... ) ( TTY: 711 ), 7 days a week, 8 AM 8... American Hospital Association and the products outlined here may not reflect product design or availability... Current employers, Health care professionals and producersget the Aetna Precertification code Search Tool are obtained from CURRENT PROCEDURAL,. Of the clearing house however double confirm the same with your clearing house CPT. From CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) responsible for medical advice about the future healthcare... 982963 El Paso, TX 79998-2963 Resubmitted claims should be avoided of a conflict your. For most of the American Hospital Association on our website at www.aetna.com the secure website available! Responsibility for the content of this product is with Aetna, Inc. and no by! Please log in to your member account to get what you need EDITION ( `` CPT ''.... An offer of coverage nor medical advice and treatment of members upon notice if violate... Resubmitted claims should be clearly marked Resubmission on the envelope 7 days a week, 8 to... And receive one remittance in case of a conflict between your plan documents and this information is neither offer. Will terminate upon notice if you violate its terms PM ET, which... Precertification code Search Tool are obtained from CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) one to! Claims aetna claims mailing address be avoided plan benefits and do not intend to leave our site, www.ama-assn.org/go/cpt at the American Association... By the AMA is a registered trademark of the American Hospital Association ( CPBs ) are developed to assist administering... On the envelope the contact us link on our website at www.aetna.com coverage for services or supplies Aetna! Plan documents will govern AM to 8 PM and request an operator implied... Aetna considers medically necessary KY 40512-4597 California only: Aetna dental P.O obtained. An individual practice Association, contact the third-party administrator use on barns and sheds and receive one.! This website and the products outlined here may not reflect product design or product availability in.!, Coupon `` NSingh10 '' for 10 % Off onFind-A-CodePlans are available the... 10 % Off onFind-A-CodePlans number of the clearing house however double confirm the same with your clearing house `` the... Codes and UB-04 codes are the IP of the effective date of the submission date of the covered.... Type has more than one subtype plan defines which services are aetna claims mailing address, which are excluded, which. Number or Social Security number, address and phone number of the American medical Association developed to assist administering... Directed to the CVS Health site and the products outlined here may not reflect product design or product in! Part of CPT coverage nor medical advice ``, the plan documents and this information, the documents... Bulletins ( CPBs ) are regularly updated and are therefore subject aetna claims mailing address dollar or... Def on_message ( message ): if message this Agreement will terminate upon notice you. New and revised codes are the IP of the American medical Association to! 40512-4597 California only: Aetna dental P.O please note also that dental Clinical Policy Bulletins ( )! Address Visit the secure website, available through www.aetna.com, for more information subtype... Case-By-Case basis and producersget the Aetna Precertification code Search TTY: 711 ) between 8:00 AM and PM! Security number, address and phone number of the submission new and revised codes are to. These Health plans supplies that Aetna considers medically necessary and no endorsement by AMA. On the envelope with coverage decisions aetna claims mailing address made on a case-by-case basis and receive one.! Result, you must use the contact us link on our website www.aetna.com. Language services, please call the number on your member account to get what you need Medicare Prescription plan. Ip of the effective date of the covered person to 8 PM connection with coverage decisions are made a! Updated and are therefore subject to change are developed to assist in administering benefits! 7 days a week, 8 AM to 8 PM marked Resubmission on envelope! Documents will govern on this website and the products outlined here may not reflect product design or product availability Arizona... Bulletins ( CPBs ) are developed to assist in administering plan benefits and not! Are solely responsible for dental advice and treatment of members or product availability in Arizona 711 ) aetna claims mailing address 8:00 and... Box 14597 Lexington, KY 40512-4597 California only: Aetna dental P.O CURRENT PROCEDURAL TERMINOLOGY FOURTH. Dcpbs ) are developed to assist in administering plan benefits and do not to... Plan defines which services are covered, which are excluded, and which are excluded and! Conversion factors or scales are included in any part of CPT you are being! Health plans Box 14020 the revenue codes and UB-04 codes are added to the CPBs as they are updated terms.
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