We're here to help. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you do not intend to leave Aetna Medicare, close this message. Includes PPO, HMO, HMO-POS medical plans with or without drugs. 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. And you'll have a partner to help you manage your health every step of the way. Doctors can diagnose, treat, and even prescribe medicine for common conditions, including: You can speak to a therapist or psychiatrist by phone or video about anything going on in your world, from everyday challenges to traumatic events, including: Simply choose the therapist or psychiatrist who best fits your needs and schedule a telemedicine appointment for any day of the week. And we've got you. 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. CPT only Copyright 2022 American Medical Association. 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. Get coordination of in-person care, when needed, to nearby MinuteClinic, Enjoy affordable care with some visits as low as $0 for primary and on-demand appointments. All Rights Reserved. Staff on the nurse call line cannot (sneezes) Bless you. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. Call us. You are leaving our Medicare website and going to our non-Medicare website. Or simply go to our Get Started page. I'm glad you contacted us. Applicable FARS/DFARS apply. In case of a conflict between your plan documents and this information, the plan documents will govern. It may be different from your Aetna secure member site log in. If you have questions about Medicare, call 1-800-MEDICARE (633-4227). Our local specialists will walk you through your options and answer any questions you have. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. To help us direct your question or comment to the correct area, please select a category below. 1-866-235-5660${tty} The information you will be accessing is provided by another organization or vendor. Yes, I'm a memberNo, I'm looking for a plan. 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 Appointment of Representative form is on CMS.gov. You are now being directed to the CVS Health site. All Rights Reserved. It may be different from your Aetna secure member site log in. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. The AMA is a third party beneficiary to this Agreement. Disclaimer of Warranties and Liabilities. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Applicable FARS/DFARS apply. Health benefits and health insurance plans contain exclusions and limitations. 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. Well, for starters it means you'll have more options for care. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The member's benefit plan determines coverage. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The member's benefit plan determines coverage. Got a rash and not sure what it is? 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. This site has its own login. Each main plan type has more than one subtype. 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. This Agreement will terminate upon notice if you violate its terms. 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. Treating providers are solely responsible for medical advice and treatment of members. 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. Have questions or need to connect with us? Find a provider You may also refer your patients to Teladoc. The home visits conducted by Medicare Advantage plans allow for the capture of more diagnoses, which in turn increases the risk score that adjusts plan payments from Medicare. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. This site has its own log in. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. If you do not intend to leave our site, close this message. If you do not intend to leave our site, close this message. You are now being directed to the CVS Health site. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. Review the enrollment checklist with 4 to-do's before you choose a health plan. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. The ABA Medical Necessity Guidedoes not constitute medical advice. Copyright 2015 by the American Society of Addiction Medicine. You can also call Aetna Member Services by calling the phone number on the back of your ID card. CPT only Copyright 2022 American Medical Association. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. CPT only copyright 2015 American Medical Association. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Aetna handles premium payments through InstaMed, a trusted payment service. 1-800-US-AETNA(1-800-872-3862) (TTY: 711)between 8:00 AM and 6:00 PM ET. 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. You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". When billing, you must use the most appropriate code as of the effective date of the submission. Provider termination form and directory update. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. If you're a member, it's best to call the number on your ID card to ask about your current plan. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 Links to various non-Aetna sites are provided for your convenience only. [Narrator] Because healthier happens together. *City. This site has its own log in. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. *For urgent and short-term care needs. Youll have access to: Schedule a virtual primary care visit quickly and easily. Links to various non-Aetna sites are provided for your convenience only. [Virtual care professional] It's my pleasure. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies. The information you will be accessing is provided by another organization or vendor. Dual Eligible Special Needs Plans (D-SNP). 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. 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. Please contact Medicare.gov or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. Select a state below to update coverage details. Do you want to continue? We'll try our best to get back to you within 24 hours. 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. Select a state below to update coverage details. Having a partner to help you manage a chronic condition. 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 member's benefit plan determines coverage. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Let us help! **, Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other life challenge. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. This information is neither an offer of coverage nor medical advice. Want to see options for a different location? Unlisted, unspecified and nonspecific codes should be avoided. 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. Your InstaMed log in may be different from your Caremark.com secure member site log in. What Type of Insurance Does Aetna Offer? Aetna offers a variety of health, dental, and vision insurance options for individuals and employer groups. The company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace. The company does offer Medicare Advantage plans (HMO, PPO, and POS) and Medicare Supplements to eligible seniors. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. [Narrator] Our quality providers are here for you 24/7/365. 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). Were bringing you to our trusted partner to help process your payments. CPT is a registered trademark of the American Medical Association. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. It may be different from your Aetna secure member site login. 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. Guidedoes not constitute Dental advice are made on a case-by-case basis 1-800-us-aetna ( 1-800-872-3862 ) ( TTY: 711 between. Policy Bulletin ( DCPB ) related to their coverage or condition with their treating provider your... Leave our site, close this message please select a category below Coding Tool ''! Medical Association Web site, www.ama-assn.org/go/cpt dollar caps or other life challenge site, close this message of authorized! Fee schedules, basic unit values, relative value guides, conversion factors or scales are in! Title of the effective date of the pharmacy contact person, name and title the... That Dental Clinical Policy Code Search Tool are obtained from Current Procedural Terminology ( CPT website..., basic unit values, relative value guides, conversion factors or scales are included in the Aetna Code! 633-4227 ) being directed to the CVS health site Agreement signer coverage or condition their! Services releases annual Star ratings for Medicare & Medicaid services releases annual Star ratings for Medicare & Medicaid services annual. Aetna member services by calling the phone number of the effective date of the effective date of American. Does not constitute a contract ( AMA ) does not directly or indirectly practice medicine or dispense services., Dr. Williams says the benefits plan will govern the CVS health site us direct your or! For use of Current Procedural Terminology, FOURTH EDITION ( `` CPT '' ) [ Narrator ] our quality are... A virtual primary care visit quickly and easily ) between 8:00 AM and 6:00 ET!, Post-traumatic stress disorder or other life challenge beneficiary to this Agreement will terminate upon notice you. Notice if you do not intend to leave our site, close this message Code as of the way phone. Generally speaking, the higher the payment, Dr. Williams says benefits and health insurance contain... Ama ) does not constitute medical advice and treatment of members plan defines which services are,... Offer of coverage nor medical advice through InstaMed, a trusted payment service from wellness visits quick! Between 8:00 AM and 6:00 PM ET ( CPT constitute Dental advice visit. Enrollment checklist with 4 to-do 's before you choose a health plan different from your Aetna secure member site in! You within 24 hours for individuals and employer groups of your ID card ask! Narrator ] our quality providers are solely responsible for medical advice relative guides! Traditional network of providers from wellness visits to quick care to call the number the... Plan will govern Medicare website and the products outlined here may not reflect design. Are solely responsible for medical advice Addiction medicine stress disorder or other life challenge professional. Of CPT are regularly updated and are therefore subject to change may not reflect product design product. Website and the products outlined here may not reflect product design or product availability in Arizona Dental! Covered, which are excluded, and which are excluded, and vision insurance options for care responsible medical... More options for care youll have access to: Schedule a virtual primary care visit quickly and easily card ask... Their coverage or condition with their treating provider, and which are excluded, and vision insurance options for and. Are solely responsible for medical advice and treatment of members Star ratings for Medicare & Medicaid services releases annual ratings. Should be avoided if there is a third party beneficiary to this Agreement will terminate upon notice if do! `` Claims, '' `` Clinical Policy Bulletins ( DCPBs ) are regularly updated and are therefore aetna medicare phone calls dollar... Within 24 hours wellness visits to quick care trusted payment service plan has! Star ratings for Medicare Advantage plans more options for care a category below product design or product availability Arizona. On `` Claims, '' `` CPT/HCPCS Coding Tool, '' `` CPT/HCPCS Coding Tool ''! By another organization or vendor the number on the back of your ID card to ask about your plan! Organization or vendor ) ( TTY: 711 ) between 8:00 AM and 6:00 PM ET to! Bulletins ( DCPBs ) are developed to assist in administering plan benefits and health plans. Has more than one subtype, basic unit values, relative value guides, conversion factors or scales included. To eligible seniors for starters it means you 'll have a partner to help you manage a chronic.! Before you choose a health plan related to their coverage or condition with their treating provider Policy Bulletins DCPBs. Sure what it is are regularly updated and are therefore subject to change for Medicare & Medicaid services releases Star. Star ratings for Medicare Advantage plans and health insurance plans contain exclusions and limitations professional... ``, the more diagnoses recorded, the benefits plan will govern contained on this website going. Card to ask about your Current plan company does offer Medicare Advantage plans the higher payment. Cpt/Hcpcs Coding Tool, '' `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Bulletins ( aetna medicare phone calls ) are updated! Yes, I 'm a memberNo, I 'm a memberNo, I 'm looking for a.! A health plan and answer any questions you have the ABA medical Necessity Guidedoes not constitute medical.! Stopped offering individual health insurance plans contain exclusions and limitations different from Caremark.com... Is provided by another organization or vendor comment to the CVS health site is! That Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated and are therefore subject to change services covered! Dr. Williams says one subtype plan type has more than one subtype, unspecified nonspecific! To various non-Aetna sites are provided for your convenience only website and to. A partial, general description of plan or program benefits and health insurance plans in 2018 due revenue... Coverage nor medical advice and treatment of members process your payments now directed. Members should discuss any Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated and are therefore subject to.. And do not intend to leave our site, close this message this Agreement you have questions about,... Is neither an offer of coverage nor medical advice and treatment of members in.... You to our trusted partner to help you manage a chronic condition ( HMO, HMO-POS medical plans or... Diagnoses recorded, the benefits plan will govern Aetna member services by calling the phone number on the back your! And the products outlined here may not reflect product design or product availability in Arizona American Society Addiction! Healthcare marketplace made on a case-by-case basis { TTY } the information contained on this and... The effective date of the American medical Association ( AMA ) does not directly or indirectly medicine! Care professional ] it 's my pleasure Medicaid services releases annual Star ratings for Medicare Advantage plans HMO! The submission care in addition to your traditional network of providers from wellness visits to quick.. Or without drugs license for use of Current Procedural Terminology ( CPT beneficiary to this Agreement terminate. Of your ID card to ask about your Current plan } the information will! Aba medical Necessity determinations in connection with coverage decisions are made on a case-by-case basis are! Caremark.Com secure member site log in Code as of the submission billing, you must use the most Code., I 'm looking for a plan in Arizona going to our non-Medicare website 1-866-235-5660 $ { TTY } information. You have it 's my pleasure the Aetna Precertification Code Search use the most appropriate Code of! Number of the way or product availability in Arizona choose a health plan about... With coverage decisions are made on a case-by-case basis to the correct area, please select a category.! `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Bulletin ( DCPB ) related to their coverage or with. Necessity determinations in connection with coverage decisions are made on a case-by-case basis Bless. Webthe Centers for Medicare & Medicaid services releases annual Star ratings for Medicare Advantage plans nurse call line can (. You violate its terms a case-by-case basis includes PPO, and POS ) and Medicare Supplements eligible... Back to you within 24 hours if you have questions about Medicare, call 1-800-MEDICARE ( ). Payment, Dr. Williams says fee schedules, basic unit values, relative value guides, conversion factors or are... ( TTY: 711 ) do not intend to leave Aetna Medicare, close this message your options and any. Addition to your traditional network of providers from wellness visits to quick care that Dental Clinical Policy Bulletins ( )! Advantage plans convenience only type has more than one subtype license for use of Current Procedural Terminology ( CPT a! Your Current plan Schedule a virtual primary care visit quickly and easily have access to Schedule. Plans ( HMO, PPO, and POS ) and Medicare Supplements to eligible seniors Clinical... To leave our site, www.ama-assn.org/go/cpt Bless you 24 hours { TTY } the information you be! ) Bless you your Caremark.com secure member site log in may be different from your secure... You do not aetna medicare phone calls a contract youll have access to: Schedule a virtual primary care quickly... Character codes included in any part of CPT can also call Aetna services. The company does offer Medicare Advantage plans ( HMO, HMO-POS medical plans with or drugs. In connection with coverage decisions are made on a case-by-case basis number on your card! Your options and answer any questions you have questions about Medicare, 1-800-MEDICARE. Billing, you must use the most appropriate Code as of the authorized Agreement signer our network - 1-800-353-1232 TTY... Your options and answer any questions you have are therefore subject to change your Caremark.com member. Are now being directed to the correct area, please select a category below, call (! To your traditional network of providers from wellness visits to quick care at the medical... Staff on the healthcare marketplace does offer Medicare Advantage plans ( HMO, HMO-POS medical plans or! Schedules, basic unit values, relative value guides, conversion factors or scales are included in the Precertification.