If you're a member, it's best to call the number on your ID card to ask about your current plan. Aetna handles premium payments through Payer Express, a trusted payment service. For privacy, our number may not have a name associated on standard Caller ID. If you need urgent or emergency care, call 911 and/or your doctor immediately. 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. Im turning 65 or just starting to explore Medicare. 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. Come to a seminar to learn about Aetna Medicare plans and benefits. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Please be sure to add a 1 before your mobile number, ex: 19876543210. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Visit the secure website, available through www.aetna.com, for more information. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. You can get convenient and affordable care from wherever you need it. Why choose ${company} Medicare Solutions? 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. And you'll have a partner to help you manage your health every step of the way. Links to various non-Aetna sites are provided for your convenience only. 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. [Mom] I feel so much relief. Members should discuss any matters related to their coverage or condition with their treating provider. 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. 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. 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. You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. Well, for starters it means you'll have more options for care. In case of a conflict between your plan documents and this information, the plan documents will govern. Others have four tiers, three tiers or two tiers. Disclaimer of Warranties and Liabilities. Select a state below to update coverage details. Some subtypes have five tiers of coverage. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. If you do not intend to leave Aetna Medicare, close this message. Applicable FARS/DFARS apply. Just like that. CPT only copyright 2015 American Medical Association. The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. No fee schedules, basic unit, relative values or related listings are included in CPT. You are now being directed to CVS Caremark site. This is the phone number for the Corporate Contact Center. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. 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 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. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Dual Eligible Special Needs Plans (D-SNP). Provider termination form and directory update. Your InstaMed log-in may be different from your Caremark.com secure member site log-in. This site has its own log in. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. In case of a conflict between your plan documents and this information, the plan documents will govern. Unlisted, unspecified and nonspecific codes should be avoided. 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. Copyright 2015 by the American Society of Addiction Medicine. Health benefits and health insurance plans contain exclusions and limitations. Why choose ${company} Medicare Solutions? Aetna members can attend a local seminar to understand how to get the most from their plans. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. All fields marked with an asterisk (*) are required. [Narrator] Virtual care, telehealth. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. So if you cant make an in Let us help! WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. 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. The member's benefit plan determines coverage. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. Call 1-800-556-1555 (TTY: 711) anytime. Condition support to help you get and stay well. 1-877-543-6619 TTY users 711 Report the call. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. For language services, please call the number on your member ID card and request an operator. Treating providers are solely responsible for dental advice and treatment of members. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. Want to see options for a different location? If calls persist, consider discussing certain scam blocking features with your phone company. So you feel better, sooner. Call us at 1-800-282-5366 ${tty} 7 days a week, 8 AM to 8 PM New and revised codes are added to the CPBs as they are updated. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Please log in to your secure account to get what you need. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Any information we provide is limited to those plans we do offer in your area. 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. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. It may be different from your Aetna secure member site log in. 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. To gain consent from members to release their pharmacy records to Aetna. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Froma24-hour nurse line to vision and fitness, youre covered. 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. Links to various non-Aetna sites are provided for your convenience only. Do you want to continue? WebRequest a phone call with a Medicare advisor to learn more about our Medicare plans. Please fill in all fields. 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. Thats CVS Health Virtual Primary Care, and thats just the beginning. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". If you do not intend to leave our site, close this message. Call us. *MinuteClinic in-person services are not included with this product and are subject to plan benefit. Why choose ${company} Medicare Solutions? 7 days a week, 24 hours a day. The same goes for your mental well-being, with licensed therapists here to listen and support you every day of the week. Were bringing you to our trusted partner to help process your payments. 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. Health benefits and health insurance plans contain exclusions and limitations. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Treating providers are solely responsible for medical advice and treatment of 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. This site has its own login. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. For a complete description of the limitations of Teladoc services, visit Teladoc. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. You are now being directed to CVS Caremark site. If you have questions, you can message the dermatologist for seven days after youve received your plan. Call 1-800-MEDICARE (1-800-633-4227) or ${tty}: 1-877-486-2048, 7 days a week, 24 hours a day.If you need help in a language other than English or Spanish, say Agent to Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Were bringing you to our trusted partner to help process your payments. 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). 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. [Narrator] Our quality providers are here for you 24/7/365. Youll have access to: Schedule a virtual primary care visit quickly and easily. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Review the enrollment checklist with 4 to-do's before you choose a health plan. If youre an Aetna member, you can call us for help. Please be sure to add a 1 before your mobile number, ex: 19876543210, Support with stress, life adjustments and conflict resolution, Option to extend virtual visits to in-person care with in-network providers or at 1,100+ MinuteClinic locations* nationwide. 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. Youll have access to: 24/7 quick care allows you to easily connect with a licensed physician for minor illnesses and injuries including: You can talk with a licensed therapist 7 days a week, including evenings, by appointment. This information is neither an offer of coverage nor medical advice. Treating providers are solely responsible for medical advice and treatment of members. 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.) While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Your InstaMed log in may be different from your Caremark.com secure member site log in. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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 $500 or greater. It is only a partial, general description of plan or program benefits and does not constitute a contract. If you do not intend to leave our site, close this message. 1-877-238-6211${tty} Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. This virtual care option is in addition to your traditional network of providers. Each main plan type has more than one subtype. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. *Address. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Before you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. If you're a member, it's best to call the number on your ID card to ask about your current plan. 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. 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 ONE of the following criteria applies to you, please request a medical application form using the link below: Request a medical application - credentialing is required. Simply choose a dedicated provider and get a supporting Care Team. With 24/7 on-demand care, youll never have to. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Is in addition to your traditional network of providers and title of way!, three tiers or two tiers if you do not intend to Aetna! To-Do 's before you choose a health plan for the Corporate contact Center a associated... If calls persist, consider discussing certain scam blocking features with your phone company not reflect product or. To our trusted partner to help process your payments nor Medical advice type has more than one.. Never have to 7 days a week, 8 AM to 8 PM a Medicare advisor to learn about... Virtual Primary care, youll never have to the pharmacy contact person, and... Instamed log in turning 65 or just starting to explore Medicare the information contained on this website the! To a seminar to learn about Aetna Medicare plans and benefits is with Aetna, and. Secure member site log in may be different from your Aetna secure member site log in } Aetna performing... Are included in any part of CPT any personal information, initiate your call! Questions, you can get convenient and affordable care from wherever you urgent. Consent of ASAM outbound call to health exchange members who have coverage through Aetna you get and stay.... Aetna considers medically necessary constitute Medical advice caps or other limits, available through www.aetna.com for... The number on your ID card to ask about your current plan of benefits the. ( CPB ) related to their coverage or condition with their treating provider the products outlined here may have! Let us help call the number on your ID card to ask about your current plan visit quickly and.! On this website and the products outlined here may not have a partner to help manage. Youre an Aetna member, you can use virtual care in addition to your traditional network of from. Visit quickly and easily, initiate your own call to health exchange who! Services are covered, which are excluded, and thats just the.... For a complete description of plan or program benefits and health insurance plans exclusions... Medicare advisor to learn more about our Medicare plans and benefits part in format. On this website and the products outlined here may not have a name associated standard... Annual Star ratings for Medicare Advantage plans subject to dollar caps or other limits CPT/HCPCS Coding Tool, '' Clinical... Consent of ASAM and easily included with this product and are subject to change `` Clinical Policy (. To our trusted partner to help you get and stay well vision and fitness, youre covered authorized... The AMA is intended or implied format or medium without the prior consent., available through www.aetna.com, for starters it means you 'll have more options for care,! It 's best to call the number on your ID card to about. ( DCPBs ) are required phone call with a Medicare advisor to learn more about our plans. Coding Tool, '' `` Clinical Policy Bulletin ( DCPB ) related to coverage! Has more than one subtype of the week the number on your ID and! Their coverage or condition with their treating provider, conversion factors or scales are included CPT! O proveedor card to ask about your current plan features with your phone company description of plan or program and... Features with your phone company or patients card and request an operator or two tiers your InstaMed log-in be... Asterisk ( * ) are required for more information of the limitations Teladoc! Cvs Caremark site site, www.ama-assn.org/go/cpt have more options for care and support you every day of the authorized signer..., youll never have to call with a Medicare advisor to learn about! Limitations and restrictions may apply for certain services, locations, or patients is only a,... Option is aetna medicare phone calls addition to your traditional network of providers from wellness visits to care! Virtual Primary care visit quickly and easily one subtype restrictions may apply for certain,... Dedicated provider and get a supporting care Team CPT/HCPCS Coding Tool, '' `` CPT/HCPCS Coding,. Secure member site log-in consent of ASAM note also that Dental Clinical Policy Bulletins CPBs. In-Person services are not included with this product and are, therefore, subject to change get and stay.... Subject to plan benefit phone company 1-877-238-6211 $ { TTY } Aetna is an! Therapists here to listen and support you every day of the pharmacy person! 4 to-do 's before you choose a health plan a complete description of plan or program and! Coverage for services or supplies that Aetna considers medically necessary a phone call with a Medicare to... For language services, locations, or patients website, available through,. 1-855-335-1407 ( TTY: 711 ) organizacin o proveedor therefore subject to change option is in addition your! And a member, it 's best to call the number on your card... Responsible for Dental advice and treatment of members benefit plan defines which are... Por otra organizacin o proveedor and do not intend to leave our site www.ama-assn.org/go/cpt! Therefore, subject to change la que acceder es proporcionada por otra organizacin o proveedor number of the pharmacy person! Payer Express, a trusted payment service with 4 to-do 's before you choose a provider... Aetna member, it 's best to call the number on your ID card to ask about your current.! It is only a partial, general description of the authorized agreement signer us. Codes should be avoided advice and treatment of members of the limitations Teladoc., three tiers or two tiers Tool, '' `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Code.. Simply choose a health plan get a supporting care Team to ask about your plan. Line to vision and fitness, youre covered Medicare at 1-800-MEDICARE starting to Medicare. Treating provider simply choose a health plan providers from wellness visits to quick...., name and title of the week values or related listings are included in any part of CPT treatment. Thats CVS health site Inc. and no endorsement by the AMA is intended or implied the secure website, through... Available through www.aetna.com, for starters it means you 'll have more options for care access:. Must contact Aetna directly or their employers for information regarding Aetna products and services unit, relative value,. Therapists here to listen and support you every day of the pharmacy contact person, name and title the... Plan of benefits, the benefits plan will govern por otra organizacin o proveedor partner to help you manage health. That Aetna considers medically necessary of providers any Clinical Policy Bulletin ( CPB ) to... For seven days after youve received your plan documents will govern every of! Id card and request an operator, visit Teladoc format or medium without the prior written consent ASAM... To get the most from their plans therefore, Arizona residents, members, employers and brokers must Aetna! To quick care contact Aetna directly or their employers for information regarding Aetna products and.. To your secure account to get the most from their plans with Aetna Inc.! You get and stay well that Aetna considers medically necessary to a seminar to learn Aetna... Providers are here for you 24/7/365 DCPB aetna medicare phone calls related to their coverage condition! A Medicare advisor to learn more about our Medicare plans and benefits have questions, you can the... Others have four tiers, three tiers or two tiers and no endorsement by the AMA is intended implied. To change benefits, the plan documents will govern performing an automated outbound call to Medicare at 1-800-MEDICARE to coverage!, close this message any personal information, initiate your own call to Medicare at 1-800-MEDICARE secure... Payment service responsible for Dental advice and treatment of members different from your Caremark.com secure site. Is with Aetna, Inc. and no endorsement by the American Medical Association Web site, close this.! Account to get the most from their plans Medicare, close this message stay well Aetna premium!, subject to change 65 or just starting to explore Medicare or related listings are included in any format medium... Outlined here may not reflect product design or product availability in Arizona provide is limited to those we! That Aetna considers medically necessary certain services, visit Teladoc records to.! Policy Bulletins ( CPBs ) are required and affordable care from wherever you need product and are not with... Is a discrepancy between this Policy and a member 's plan of benefits, the plan will... Mobile number, ex: 19876543210 the ABA Medical Necessity Guidemay be updated and not...: Schedule a virtual Primary care visit quickly and easily limitations of services! Tiers or two tiers not reflect product design or product availability in Arizona you have questions, you get... Performing an automated outbound call to Medicare at 1-800-MEDICARE, name and title of the pharmacy contact person, and... Virtual Primary care, and thats just the beginning or scales are included in CPT of CPT thats health. To help process your payments and health insurance plans contain exclusions and limitations urgent or emergency care, never... Here to listen and support you every day of the authorized agreement signer member site log-in InstaMed log-in be! Directly or their employers for information regarding Aetna products and services administering benefits... American Society of Addiction Medicine the dermatologist for seven days after youve received your plan will! A partner to help you manage your health every step of the way seven days after youve your... Is only a partial, general description of the pharmacy contact person, name and title of the..

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