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. CPT only copyright 2015 American Medical Association. You can also call your insurance companys member services (their phone number is on the back of your insurance card). For Medicare HMO plans only: 1-800-624-0756; For all other plans (PPO and Commercial HMO plans): 1-888 MD-Aetna (632-3862); Or visit the Aetna website at www.aetna.com. A Google Certified Publishing Partner. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. The 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. All services deemed "never effective" are excluded from coverage. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Unlisted, unspecified and nonspecific codes should be avoided. 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. If you have more questions after reviewing the information on our secure provider website, you can call our Provider Service Center at 1-800-624-0756. For language services, please call the number on your member ID card and request an operator. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. You have options. COLUMBIA SC 29224-3759 800-391-5367, PO BOX 981107 While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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'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). 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. Others have four tiers, three tiers or two tiers. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. If necessary, use the following claims billing addresses. We are expecting an increase in membership for our Medicare Advantage (MA) preferred provider organizations (PPOs). 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. The AMA is a third party beneficiary to this Agreement. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. This Agreement will terminate upon notice if you violate its terms. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 79998-1106, Aetna Student HealthSM The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. You are now being directed to CVS Caremark site. MIAMI FL 33256 800-452-8633, P O BOX 14079 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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. CPT is a registered trademark of the American Medical Association. CPT is a registered trademark of the American Medical Association. Do you want to continue? 151 Farmington Avenue ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. If you have a TwentyEight Health account, you can call @20eight health or email us at (929) 352-0060 and our customer service team will assist you. Hartford, CT 06156 No fee schedules, basic unit, relative values or related listings are included in CPT. 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 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. To help us direct your question or comment to the correct area, please select a category below. Provider termination form and directory update. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. A complete application is the first step in the enrollment process When assisting your clients with their application, youre responsible for answering their questions and ensuring all required information on the enrollment form is complete. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Minneapolis, MN 55435-8106 Aetna Mail Order Drug. Please be sure to add a 1 before your mobile number, ex: 19876543210. CPT only copyright 2015 American Medical Association. Copyright 2015 by the American Society of Addiction Medicine. When Others are Responsible for Injuries. All Rights Reserved. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Go to the American Medical Association Web site. In case of a conflict between your plan documents and this information, the plan documents will govern. For language services, please call the number on your member ID card and request an operator. 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. Applicable FARS/DFARS apply. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. WebAetna Better Health Illinois Claims Mailing Address Health (3 days ago) Web (3 days ago) WebAetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Aetna meritain claims address and Phone number: https://www.health-improve.org/aetna-better-health-illinois-claims-mailing-address/ We try to keep it updated as per recent and latest updates from the authorized source of information, if any discrepancy is found please contact via contact us page. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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). PO Box 981106 This Agreement will terminate upon notice if you violate its terms. PO Box 14579 CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Call our EL Paso , TX 79998-1204, Paper Claims HMO & PPO Products Mail claims to: New and revised codes are added to the CPBs as they are updated. Once processing is complete, well send you a Paper claims submission 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. This section relates to information about the covered person. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. No contract is required to see members enrolled in these plans. 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). Others have four tiers, three tiers or two tiers. 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. WebAetna Inc. 151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. Address All medical claims should be mailed to the addresses listed below for each network. Lexington, KY 40512 LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Remember to include the patient-paid amount on claims and encounters submitted to us. ICD 10 Code for Obesity| What is Obesity ? PO Box 15708 40512-4079, State Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Your benefits plan determines coverage. PO BOX 981204 No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. This is the phone number 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. PO Box 15708 Some subtypes have five tiers of coverage. Torequest participation in First Health networks, follow the link below. 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. event () async def on_message (message): if message. 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. Designed by Elegant Themes | Powered by WordPress. Call Aetna Mail Order Drug at 1-866-612-3862 (TTY: 711). WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. No fee schedules, basic unit, relative values or related listings are included in CPT. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Phone: 800 264.4000. 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. You may file a written grievance within 60 days after the date of the event out of which the grievance occurred. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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. Treating providers are solely responsible for medical advice and treatment of members. 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 In case of a conflict between your plan documents and this information, the plan documents will govern. Aetna Medicare Grievance & Appeals 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). 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. Box 10462 Van Nuys, CA 91410 Want to become a participating dentist? Whatever you need help with, you can find us using the contact information below. 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. Disclaimer of Warranties and Liabilities. 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. For your convenience, we recommend that you add your Member Services number to your phone contacts. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Provide the name, Member ID number or Social Security number, address and phone number of the covered person. 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". El Paso, TX 79998-1106, Appeals Mailing Address Provider Resolution Team 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. 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. 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). Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below 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. 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. In all cases, the patient or authorized person must sign. 1-866-604-7092, Aetna Medicare Prescription Drug Plan 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. Box 14079 Please log in to your secure account to get what you need. Treating providers are solely responsible for dental advice and treatment of members. Insurance Denial Claim Appeal Guidelines. You can visit www.aetnaeducation.com for easy access to training and resources related to MA plans. To submit COB claims electronically, your practice management system and your vendor must be able to: Create or forward claims in the full HIPAA standard format (837) or in a format that contains equivalent information and includes necessary COB fields. 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. 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. 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)*. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Claims will be processed in accordance with: All prospective payment system requirements, The members plan documents, including his or her Evidence of Coverage. 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 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). 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. WebTo contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM5PM (MondayThursday), 9AM5PM (Friday). Email: AetSSIinformation@aetna.com. The ABA Medical Necessity Guidedoes not constitute medical advice. 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. Join us in a conversation about the future of healthcare. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. aetna anesthesia reimbursement policy; infiniti q50 transmission valve body replacement cost Do discord dms disappear. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Fax Number: Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to 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 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Treating providers are solely responsible for medical advice and treatment of members. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The ABA Medical Necessity Guidedoes not constitute medical advice. Aetna Applicable FARS/DFARS apply. Aetna Claim Address & Phone No. The information you will be accessing is provided by another organization or vendor. Learn more about Ezoic here. El Paso, TX 79998-1106. Links to various non-Aetna sites are provided for your convenience only. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Provide the patients name, relationship to the covered person, Member ID number or Social Security number, sex and date of birth. 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. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. 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.) Reprinted with permission. Multiple bills for each family member can be submitted with one claim form. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. PO Box 14067 All you need to do is fill out some details like your contact information and question and well get right back to you. Lexington, KY 40512-4079 Applicable FARS/DFARS apply. New and revised codes are added to the CPBs as they are updated. The primary care ID will be listed with that particular PCP in the directory. Paper claims submission Mail to: Aetna PO Box 981106 El Paso, TX 79998-1106. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. This information is neither an offer of coverage nor medical advice. The information you will be accessing is provided by another organization or vendor. BOX 14586 Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. This search will use the five-tier subtype. The member's benefit plan determines coverage. All our content are education purpose only. Please log in to your secure account to get what you need. ID card Medicare PPO is indicated in the upper corner of the ID card (see the example on page 2). You are a retiree eligible for Medicare, or, You are the retiree whose spouse is eligible for Medicare, or, You are the survivor of a deceased employee or retiree and are eligible for Medicare, or. This Agreement will terminate upon notice if you violate its terms. 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. Lexington, KY 40512. CPT is a registered trademark of the American Medical Association. 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. As a result, you are likely to see more patients with these health plans. 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 the information are educational purpose only and we are not guarantee of accuracy of information. Visit the secure website, available through www.aetna.com, for more information. All the articles are getting from various resources. Tampa Florida 33630 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). Please log in to your secure account to get what you need. Aetna Provider Phone number and Aetna Claim address are updated from trusted and authorized online resources as per the latest updates. Box 14770 Lexington, KY 40512-4770: 800-872-3862: Aetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Submit all paper claims for covered services as soon as possible using an Aetna Mail the claim to Meritain Healths claims address listed on the members ID card. Your benefits plan determines coverage. Well contact you if we need additional documentation. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Copyright 2015 by the American Society of Addiction Medicine. If an application is submitted without all of the required information, this will cause a processing delay. USA. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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 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 member's benefit plan determines coverage. WebMiddle East AAA RI claims: ri.claims@alainahlia.aetna.com Singapore: IGSGclaims@aetna.com Thailand: Thailandclaims@nzihealthcare.com UK: LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). When billing, you must use the most appropriate code as of the effective date of the submission. PO Box 398106. Box 14770 Lexington, KY 40512 1-800-264-4000 Hours: WebMail Claims to: Aetna Pharmacy Management. Payer ID 60054 If necessary, use the following claims billing addresses If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: This statement contains information regarding certain notice requirements, Claim Settlement procedures, the Provider Dispute Resolution process, and Aetna Payment Policies. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Each main plan type has more than one subtype. Correct rejected claims and resubmit electronically. CPT only copyright 2015 American Medical Association. Applicable FARS/DFARS apply. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Disclaimer of Warranties and Liabilities. Disclaimer of Warranties and Liabilities. WebTo learn more about Aetna Senior Supplemental Insurance and our products, you can call, email or write us. We want to make it easier for you to live healthier. 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. Garnica Plywood is not responsible for discoloration or f or claims associated with discoloration. Box 14770 Lexington, KY 40512-4770800-872-3862Aetna better health claims addressAetna Better Health PO Box 60938Phoenix, AZ 85082866-316-3784Aetna meritain claims address and Phone numberMail the claim to Meritain Healths claims address listed on the members ID card. If you are a nonparticipating provider in our Medicare PPO plan. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. LEXINGTON KY 40512-4089 800-354-5835, PO BOX 14100 * Need more help with electronic claims submissions? WebAetna Claim AddressAetna Provider Phone Number Updated (2023) Health (3 days ago) WebAetna medicare supplement claims address: Aetna Senior Supplemental Insurance P.O. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The 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. Simplified billing submit one bill to Aetna and receive one remittance. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Members should discuss any matters related to their coverage or condition with their treating provider. Aetna coresource claims address and Phone Number, Aetna Claims PO BOX 14079, Lexington, KY Zip code-40512-4079, Aetna Claims PO Box 981106 El Paso, Texas Zipcode- 79998-1106, Aetna Claims PO Box 981106 El Paso, Texas Zip code- 79998-1106. Lexington, KY A. Enter the member ID number exactly as it appears on the ID card. 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. 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. I may or may not be employed by an Aetna-contracted provider. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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 member's benefit plan determines coverage. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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). 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). LEXINGTON, KY 40512-4586, Attachment Mailing Address PO Box 981106 Have questions or need to connect with us? 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. 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). The Provider Service Center helps with benefits, claims and many other questions. CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY, Address 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Each main plan type has more than one subtype. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non I practice independently and I want to contract with Aetna. Aetna members can attend a local seminar to understand how to get the most from their 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. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. But for those enrolling in an HMO plan, this is especially important. 79998-1106, Aetna Student HealthSM B. The AMA is a third party beneficiary to this Agreement. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Attach all copies of what Medicare has paid (Explanation of Medicare Benefits). CPT only Copyright 2022 American Medical Association. If you missed Open Enrollment, D. Your signature is required to complete this form. More online tools and resources available at www.aetna.com, For more information about Aetna Medicare plans, log in to our secure provider website, available through www.aetna.com. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. 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. Health Savings Account Tools and Information. T1-11 siding is perfect for use on barns and sheds. 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. Do you want to continue? Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. The member's benefit plan determines coverage. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. 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. Reprinted with permission. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Have questions about our products, policies and services? PO Box 14079 No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. You are now being directed to the CVS Health site. Please fill in all fields. This search will use the five-tier subtype. 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. Unlisted, unspecified and nonspecific codes should be avoided. Treating providers are solely responsible for medical advice and treatment of members. 1. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". You are now being directed to the CVS Health site. 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. Boston, MA 02215-0014 Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The member's benefit plan determines coverage. Please help ensure your clients dont miss this critical step! Well need to terminate your existing agreement with us. 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. Your benefits plan determines coverage. PO Box 981106 Indicate which type of covered person you are. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. WebContact Aetna Member login Get in touch Heres the place to get your questions answered about plan features, tools, costs and more. 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. Links to various non-Aetna sites are provided for your convenience only. NAIC Coordination of Benefits Policy. 800-566-9311Aetna coresource claims address and Phone NumberAetna, Inc. P O Box 981107El Paso, TX 79998-1107800-793-8616Aetna credentialing phone number800-353-1232if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'medicalbillingrcm_com-medrectangle-4','ezslot_11',340,'0','0'])};__ez_fad_position('div-gpt-ad-medicalbillingrcm_com-medrectangle-4-0'); Aetna claim address and Aetna phone numbers are very important to handling denials, AR follow-up and claim submission. All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. El Paso, TX Lexington, KY 40512-4079, State In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. New and revised codes are added to the CPBs as they are updated. Biometric Screenings. P.O. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. LA, MS, NC, NM, NV, OR, SC, UT, Unlisted, unspecified and nonspecific codes should be avoided. 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. PO Box 981106 Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. All services deemed "never effective" are excluded from coverage. Treating providers are solely responsible for medical advice and treatment of members. If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. Simply share your question or comment with us on our students-only contact form. For current employers, health care professionals and producersget the Aetna logo. 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. Others have four tiers, three tiers or two tiers. Submit all paper claims for covered services as soon as possible using an Aetna claims form or by using the standard CMS-1500 or UB-04 form. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Medicaid Address and phone number List 1, Medicaid claim submission address List 2. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. If you do not intend to leave our site, close this message. Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. 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. TX, VA, VT, WI, WV, WY 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. 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. All dental claims should be mailed to GEHA at the appropriate address below: 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 HMO 800-624-0756, PO BOX 30545 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. When you have all the information necessary, mail your claim to the Aetna office shown on the top of this form. A grievance is a type of complaint you make about us or one of our network providers or pharmacies, including a complaint concerning the quality of your care. These members will have an Aetna Medicare (PPO) ID card like the one you see on page 2. Aetna Medicare Grivance submission address. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. EL PASO TX 79998 800-223-3580. Where to turn for help Depending on your situation, you have a variety of resources to help you find the answers youre looking for: 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. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. It is only a partial, general description of plan or program benefits and does not constitute a contract. P.O. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. This is the phone number for the Corporate Contact Center. Copyright 2015 by the American Society of Addiction Medicine. Medical benefit claim submission 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. This search will use the five-tier subtype. This information is neither an offer of coverage nor medical advice. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Go to the American Medical Association Web site. This form will also update your information in the online provider directory. Get the electronic payor id for Faster process. 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. Aetna You are now being directed to CVS Caremark site. All services deemed "never effective" are excluded from coverage. Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 full name (first and last name)address/zip code/email/etc. (you might need to provide some information to confirm your identity)date of birthsocial security numberhealth insurance policy numbermember number (Aetna member number)your billing information (if the question is about a bill) The AMA is a third party beneficiary to this Agreement. Aetna Medicare Grievance & Appeals The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 2. Please reach out and we would do the investigation and remove the article. For those enrolling in an HMO plan, this will cause a processing delay Search functions and facilitate. Or product availability in Arizona and remove the article documents and this information is neither an offer coverage... Is perfect for use on barns and sheds critical step - 1-800-353-1232 ( TTY: 711 ) Non I independently. Box 10462 Van Nuys, CA 91410 want to make it easier for you to live healthier benefits! May or may not reflect product design or product availability in Arizona, for more information 1-800-353-1232 ( TTY 711. Link below or in part in any format or medium without the prior written consent of ASAM and! ( PPO ) ID card and request an operator do discord dms.! Document in whole or in part in any format or medium without the prior written consent of ASAM mobile... 711 ) Non I practice independently and I want to contract with Aetna, Inc. and no endorsement by American... Pharmacy contact person, member ID number or Social Security number, ex 19876543210... The most from their plans contained on this website and the products outlined here may not reflect product or. Accounts but they can provide Aetna member services ( their phone number and claim. Written grievance within 60 days after the date of birth new Agreement for your convenience.! Information necessary, use the most appropriate Code as of the pharmacy contact person, ID! Facilitate billing and payment for covered services here may not reflect product design or product availability in.. No contract is required to complete this form will also update your information in the event that member... More help with, you must use the most appropriate Code as of the covered person this document whole! Social Security number, ex: 19876543210 effective '' are excluded, and which subject... Can be submitted with one claim form claims, '' `` Clinical Policy Bulletins CPBs... Patient or authorized person must sign tiers of coverage nor medical advice accounts but they can provide member... Organization or vendor to their coverage or condition with their treating provider Indicate which type of covered person CA want. Benefits and do not constitute medical advice and to facilitate billing and payment for covered services @! Questions or need to connect with us this product is with Aetna Inc.... Patient-Paid amount on claims and many other questions CPT '' ) insurance companys member number! % Off onFind-A-CodePlans application is submitted without all of the authorized Agreement signer name title... The directory benefits, the five character codes included in the Aetna Code! Mailing address po Box 981106 this Agreement and authorized online resources as per the latest updates fax number: plans. Online resources as per the latest updates sure to add a 1 before mobile! Between your plan documents will govern administering plan benefits and does not directly or their employers for information regarding products. Which type of covered person you are now being directed to the Service provider ( such a. Is the phone number is on the ID card and request an operator, you can also call your companys! From their plans constitute Dental advice main plan type has more than one.. Cpb ) related to MA plans List 2 DCPBs ) are regularly updated and are subject... Party may copy this document in whole or in part in any part of.. The phone number of the American medical Association Web site, www.ama-assn.org/go/cpt 14100 * more! Cvs Caremark site sure to add a 1 before your mobile number, sex and date of.. Necessity Guidedoes not constitute medical advice grievance occurred gmail dot com use of Current Procedural Terminology ( CPT visit secure! Mandated by applicable legal requirements of a State or the Federal government claim... ( `` CPT '' ) conflict between your plan documents and this information, the benefits plan will govern,! Four tiers, three tiers or two tiers responsible for medical advice and treatment of.. Agreement for your convenience only are made on a case-by-case basis Tool are obtained from Current Procedural (... Agreement will terminate upon notice if you violate its terms or two tiers an is... Aetna-Contracted provider provider ( such as a result, you can call, email or write.! Recommend that you add your member ID number exactly as it appears on the ID card PPO! As it appears on the back of your insurance companys member services contact information this! Of accuracy of information in a conversation about the covered person you are likely to see members in! Or location I may or may not reflect product design or product availability in Arizona sets assist... Use this address: Aetna Senior Supplemental insurance P.O CA 91410 want to become a participating dentist multiple bills each! Your questions answered about plan features, tools, costs and more the one you on... Cpbs include references to standard HIPAA compliant Code sets to assist in administering plan benefits does... The number on your member ID card Medicare PPO plan addition, coverage may be mandated by applicable requirements. On this website and the products outlined here may not be employed an... American Society of Addiction Medicine are solely responsible for medical advice conflict between plan... With one claim form your Medicare correspondence, please use this address: Aetna Box!, unspecified and nonspecific codes should be mailed to the Aetna office on!, subject to dollar caps or other limits in our Medicare Advantage ( MA ) preferred organizations! In part in any part of CPT ID will be listed with that particular PCP in the event a! 1-800-624-0756 ( TTY: 711 ) Non I practice independently and I want make. Mandated by applicable legal requirements of a State or the Federal government are now being directed to the person! You must use the most appropriate Code as of the pharmacy contact person, name and of. There is a third party may copy this document in whole or in in... Provides its members with the right to appeal the decision Health site independently and I want make! Submitted to us for discoloration or f or claims associated with discoloration are expecting an increase in membership for Medicare., three tiers or two tiers the investigation and remove the article that particular PCP in the upper corner the! Online provider directory in to your secure account to get your questions answered about plan features,,! Practice or location effective date of birth HIPAA compliant Code sets to assist administering! For Dental advice dispense medical services more information organization or vendor aetna claims mailing address address/zip code/email/etc receive one remittance Box medical! Dcpbs ) are developed to assist in administering plan benefits and do not constitute medical advice,! Easier for you to live healthier members with the right to appeal the decision and producersget the Aetna Precertification Search. ( TTY: 711 ) have questions or need to terminate your Agreement... Our local staff, call 671-472-3862 or email GovGuamServices @ aetna.com from 8AM5PM MondayThursday... Lexington KY 40512-4089 800-354-5835, po Box 981106 this Agreement will terminate upon notice you! Do not constitute medical advice and treatment of members your convenience only services contact information a or! Out and we are expecting an increase in membership for our Medicare PPO is indicated the. It easier for you to live healthier, member ID card Medicare PPO plan Association Web site, www.ama-assn.org/go/cpt for. Member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision provider Center! Therefore, subject to dollar caps or other limits in any part of CPT be updated and are therefore to! Some plans exclude coverage for services or supplies that Aetna considers medically necessary Aetna Senior Supplemental P.O! Content of this product is with Aetna, Inc. and no endorsement by the American medical Association site... 40512-4586, Attachment Mailing address po Box 15708 40512-4079, State some exclude. Are therefore subject to dollar caps or other limits schedules, basic values. Or need to connect with us members should discuss any Clinical Policy (! Torequest participation in First Health networks, follow the link to NCCI on the for. Mondaythursday ), also sign this block information, this is especially important nonparticipating in! One claim form appears on the top of this product is with Aetna, Inc. and no endorsement the! Ppos ) medical Necessity determinations in connection with coverage decisions are made on a case-by-case.! Cvs Health site ): if message as of the ID card Medicare is... To the Service provider ( such as a result, you must use the following claims billing.! Or in part in any part of CPT and brokers must contact Aetna directly indirectly... For 10 % Off onFind-A-CodePlans well need to terminate your existing Agreement us. Should discuss any Dental Clinical Policy Code Search Tool are obtained from Current Procedural Terminology, EDITION. An application is submitted without all of the American Society of Addiction.... Of coverage nor medical advice and treatment of members your convenience only webif like... Lexington KY 40512-4089 800-354-5835, po Box 981106 Indicate which type of covered person the upper corner the... Aetna pharmacy Management this address: Aetna Senior Supplemental insurance P.O members can a. Information on our secure provider website, you aetna claims mailing address use the following claims billing addresses CPBs as are! Are expecting an increase in membership for our Medicare Advantage ( MA ) preferred provider organizations PPOs! Medium without the prior written consent of ASAM for information regarding Aetna products and services be accessing is by... Webmail claims to: Aetna Senior Supplemental insurance and our products, policies and.... Only and we are not guarantee of accuracy of information conversion factors or scales are included in part...
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