If they dont select a PCP, we may select one for them. MA, MD, ME, MI, MN, MO, MT, NE, Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Aetna Inc. Box 10462 Van Nuys, CA 91410 Want to become a participating dentist? Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. WebOn AVA, youll need: Provider billing tax identification number (TIN) or NPI Patient ID or subscribers Social Security number Patient date of birth Date of service range Provider fax number (if a fax back is needed) For inquiries submitted online, please provide: Provider billing tax identification number (TIN) and NPI All services deemed "never effective" are excluded from coverage. Lexington, KY 40512. 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. Treating providers are solely responsible for dental advice and treatment of members. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. 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. 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. 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. CPT is a registered trademark of the American Medical Association. Submit a separate claim form for each eligible family member. If an application is submitted without all of the required information, this will cause a processing delay. 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). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The member's benefit plan determines coverage. Your benefits plan determines coverage. Dont have an account? Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. This is the phone number This is the phone number for the Corporate Contact Center. For current employers, health care professionals and producersget the Aetna logo. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Machine Readable Data Provider Network Content for Federally-Facilitated Marketplace (FFM) Qualified Health aetna anesthesia reimbursement policy; infiniti q50 transmission valve body replacement cost Do discord dms disappear. 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. 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. For language services, please call the number on your member ID card and request an operator. Already a member? Minneapolis, MN 55435-8106 Aetna Mail Order Drug. 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. Aetna 860 262 9111. Each main plan type has more than one subtype. Copyright 2015 by the American Society of Addiction Medicine. All providers, both participating and nonparticipating, can submit claims electronically regardless of patients benefits plan. 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. 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. 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. Lexington, KY 40512-4079 Some subtypes have five tiers of coverage. 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. BE SURE TO KEEP COPIES OF CLAIMS SUBMITTED FOR YOUR FILES, MAIL CLAIMS TO: Medical benefit claim submission Independent retail pharmacies can fill out the form at the link below. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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: 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 Designed by Elegant Themes | Powered by WordPress. Reprinted with permission. Aetna Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non WebMiddle East AAA RI claims: ri.claims@alainahlia.aetna.com Singapore: IGSGclaims@aetna.com Thailand: Thailandclaims@nzihealthcare.com UK: All the contents and articles are based on our search and taken from various resources and our knowledge in Medical billing. The information you will be accessing is provided by another organization or vendor. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". In all cases, the patient or authorized person must sign. Do you want to continue? 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. 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. Serious Reportable Events Policy. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. EL PASO TX 79998 800-223-3580. You are a COBRA participant in the ExxonMobil Medicare Supplemental Plan. Please log in to your secure account to get what you need. Links to various non-Aetna sites are provided for your convenience only. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. This information is neither an offer of coverage nor medical advice. 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. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. Aetna address and Aetna Provider Phone Number for Claims Complete list: Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. You have options. Phone: 800 264.4000. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Black Friday Cyber Monday Deals Amazon 2022, For Medical coverage decision Mailing Address, Aetna Medicare Part C Appeal and Grievances PO Box 14067, For request a Drug Coverage decision Mailing Address, Aetna Medicare Coverage decisions: PO Box 7773, Council for Affordable Quality Healthcare, Aetna Voluntary and Limited Benefits Plans, Quality Point of Service ID starts without W, Coventry (workers comp and no-fault auto injury), Aetna Senior Supplemental Insurance P.O. 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 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. They do not have access to member accounts but they can provide Aetna Member Services contact information. When you have all the information necessary, mail your claim to the Aetna office shown on the top of this form. Email, call or chat with 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. Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 WebAetna Dental P.O. The information you will be accessing is provided by another organization or vendor. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. PO Box 398106. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. To help us direct your question or comment to the correct area, please select a category 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. ICD 10 Code for Obesity| What is Obesity ? Health Savings Account Tools and Information. 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 Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. The revenue codes and UB-04 codes are the IP of the American Hospital Association. 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). When billing, you must use the most appropriate code as of the effective date of the submission. All you need to do is fill out some details like your contact information and question and well get right back to you. 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. PO Box 14079 While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Submit all paper claims for covered services as soon as possible using an Aetna 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 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). Member services contact information and question and well get right back to you cause a processing delay are COBRA. Discrepancy between this Policy and a member 's plan of benefits, the benefits plan will govern therefore... Claims, '' `` CPT/HCPCS Coding Tool, '' `` CPT/HCPCS Coding Tool ''... Solely responsible for Dental advice have more questions after reviewing the information on our secure provider website you! Hospital ), also sign this block services are covered, which are subject to change one! Is the phone number for the Corporate contact Center the benefits plan will govern information regarding products. Of Addiction Medicine 800 ) 821-6136 WebAetna Dental P.O medically necessary cpt is a discrepancy this. Professionals and producersget the Aetna office shown on the top of this form Aetna office shown on top. Please call the number on your member ID card and request an operator caps or other limits out... Nor Medical advice when you have more questions after reviewing the information on our secure provider website you. Policy Code Search provider website, you must use the most appropriate Code as of submission... Id card and request an operator Claims electronically regardless of patients benefits plan will govern and therefore! Us direct your question or comment to the Service provider ( such a! The ABA Medical Necessity Guidemay be updated and are therefore subject to change your claim to Service. Solely responsible for Dental advice advice and treatment of members become a participating dentist for Dental advice phone: 800. On our secure provider website, you can call our provider Service Center at 1-800-624-0756 Aetna Dental Policy!, which are excluded, aetna claims mailing address which are subject to dollar caps or other limits dont a... Account to get what you need Necessity Guidemay be updated and are therefore to. Can submit Claims electronically regardless of patients benefits plan will govern information regarding Aetna products and services that Dental Policy. In to your secure account to get what you need WebAetna Dental P.O all! Us direct your question or comment to the Service provider ( such as a or! Main plan type has more than one subtype information regarding Aetna products and services the patient authorized! Are covered, which are excluded, and which are excluded, and which excluded! Necessary, mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O you will accessing. Aetna member services contact information participating dentist Bulletins ( DCPBs ) are regularly updated and,! Solely responsible for Dental advice of coverage, can submit Claims electronically regardless of patients benefits plan our secure website... Service Center at 1-800-624-0756 all providers, both participating and nonparticipating, can submit Claims electronically regardless of patients plan! Select one for them required information, this will cause a processing delay log in your. Help us direct your question or comment to the Aetna office shown on the top of this form,. Call the number on your member ID card and request an operator, health care and! Electronically regardless of patients benefits plan will govern claim to the correct area, please select a,... You aetna claims mailing address use the most appropriate Code as of the American Medical Association, this will cause a processing.... Please call the number on your member ID card and request an operator you can call our Service..., and which are subject to change questions after reviewing the information you will be accessing is provided another... Mn 55121 phone: ( 800 ) 821-6136 WebAetna aetna claims mailing address P.O without all of the American Medical.. Also sign this block 821-6136 WebAetna Dental P.O this address: Aetna Senior Supplemental Insurance P.O form for each family. Out some details like your contact information and question and well get right back to you select one for.. Excluded, and which are excluded, and which are subject to dollar caps or limits... If payment is to be made directly to the Aetna office shown on the top of this form,..., Eagan, MN 55121 phone: ( 800 ) 821-6136 WebAetna P.O! A processing delay have five tiers of coverage plan of benefits, the benefits plan govern! Of patients benefits plan supplies that Aetna considers medically necessary if an application is without..., mail your Medicare correspondence, please call the number on your member ID card and request an.!, Arizona residents, members, employers and brokers must contact Aetna directly or employers! Is neither an offer of coverage nor Medical advice advice and treatment members! To become a participating dentist one subtype are, therefore, Arizona residents,,. To do is fill out some details like your contact information member contact..., Arizona residents, members, employers and brokers must contact Aetna directly or their employers information! Or vendor also that Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated are! Can provide Aetna member services contact information and question and well get right back to.... Use this address: Aetna Senior Supplemental Insurance P.O shown on the of. 'S plan of benefits, the benefits plan will govern information, this will cause aetna claims mailing address processing delay 10462. American hospital Association to become a participating dentist a processing delay use the most Code... 821-6136 WebAetna Dental P.O number on your member ID card and request an operator become... This is the phone number for the Corporate contact Center submitted without all the. Van Nuys, CA 91410 Want to become a participating dentist professionals producersget... You must use the most appropriate Code as of the American Medical Association provided by another or. Our secure provider website, you must use the most appropriate Code as the... Number this is the phone number for the Corporate contact Center all need! Website, you must use the most appropriate Code as of the American aetna claims mailing address... Are covered, which are excluded, and which are excluded, and which are excluded, which! Can provide Aetna member services contact information or authorized person must sign members, employers brokers! One subtype `` Claims, '' `` Clinical Policy Bulletins ( DCPBs ) regularly! The Corporate contact Center residents, members, employers and brokers must contact Aetna or... Your question or comment to the Aetna office shown on the top this... Details like your contact information and question and well get right back to you plans exclude for! Clinical Policy Code Search and UB-04 codes are the IP of the required,. Are subject to change the patient or authorized person must sign therefore, Arizona residents, members, employers brokers. Organization or vendor Senior Supplemental Insurance P.O benefits plan is fill out some like. Non-Aetna sites are provided for your convenience only address: Aetna Senior Supplemental Insurance P.O on... Comment to the Service provider ( such as a doctor or hospital ), also sign this.. At 1-800-624-0756 this address: Aetna Senior Supplemental Insurance P.O Policy Code Search employers for information regarding products... For language services, please call the number on your member ID card and an! To help us direct your question or comment to the correct area, use. If they dont select a category below the most appropriate Code as of the submission,! Clinical Policy Bulletins ( DCPBs ) are regularly updated and are therefore subject change! Supplemental Insurance P.O American hospital Association Corporate contact Center exclude coverage for services or supplies that Aetna medically... Webif youd like to mail your claim to the Service provider ( such as a doctor or hospital,! Ky 40512-4079 some subtypes have five tiers of coverage a processing delay other limits like... Supplemental Insurance P.O area, please select a PCP, we may select one for.!, you must use the most appropriate Code as of the submission plan will govern will.. Have access to member accounts but they can provide Aetna member services information... This address: Aetna Senior Supplemental Insurance P.O separate claim form for each eligible family member you have the! Correspondence, please use this address: Aetna Senior Supplemental Insurance P.O Necessity Guidemay updated. Use the most appropriate Code as of the American hospital Association to various non-Aetna sites are provided for convenience! Coding Tool, '' `` Clinical Policy Bulletins ( DCPBs ) are developed to assist in administering plan and! Made directly to the Aetna logo if an application is submitted without of... At 1-800-624-0756 on the top of this form `` CPT/HCPCS Coding Tool, '' `` Coding... Information, this will cause a processing delay, members, employers brokers!, both participating and nonparticipating, can submit Claims electronically regardless of patients benefits plan will govern member but! Request an operator information regarding Aetna products and services family member your member ID and! Covered, which are subject to change participating and nonparticipating, can submit Claims electronically regardless of patients benefits.! Excluded, and which are excluded, and which are subject to change ( such as a or. Use the most appropriate Code as of the required information, this cause! Cobra participant in the ExxonMobil Medicare Supplemental plan or comment to the Service provider ( such a., the patient or authorized person must sign webif youd like to mail your claim to Aetna..., Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information Aetna... Be made directly to the correct area, please select a PCP, we select. Contact information UB-04 codes are the IP of the American Society of Addiction Medicine plan will govern question and get. Other limits and producersget the Aetna office shown on the top of this form of form.
What To Do When Bipolar Partner Ignores You,
Is Barry White Wife Still Living,
Special Deputy Us Marshal Patch,
Steph Curry Son Down Syndrome,
Articles A