The member's benefit plan determines coverage. [Virtual care professional] It's nice to see you. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. And you can extend your care to be seen in-person with an in-network provider or schedule an appointment at your local Minute Clinic, just like that. 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. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. This search will use the five-tier subtype. CPT is a registered trademark of the American Medical Association. Aetna Medicare is a HMO, PPO plan with a Medicare contract. 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 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). All Rights Reserved. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Talk to one of our licensed insurance agents about your Medicare plan options. We're here to help. Unlisted, unspecified and nonspecific codes should be avoided. You are now being directed to CVS Caremark site. 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). If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. You cant trust caller id. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. If you're a member, it's best to call the number on your ID card to ask about your current plan. 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. 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. When billing, you must use the most appropriate code as of the effective date of the submission. 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). Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), 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. 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. The information you will be accessing is provided by another organization or vendor. 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. 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. 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. 3. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. All Rights Reserved. Visit the secure website, available through www.aetna.com, for more information. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. CPT only copyright 2015 American Medical Association. We know insurance is confusing and you have questions. Send us an email and well get back to you as soon as possible. Why choose ${company} Medicare Solutions? You can also call Aetna Member Services by calling the phone number on the back of your ID card. 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.) When billing, you must use the most appropriate code as of the effective date of the submission. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Flexible appointments work with your busy schedule for things like: **Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive services at no cost-share. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Members should discuss any matters related to their coverage or condition with their treating provider. For a complete description of the limitations of Teladoc services, visit Teladoc. Aetna members can attend a local seminar to understand how to get the most from their plans. Others have four tiers, three tiers or two tiers. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. 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). Fields marked with an asterisk (*) are required. 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 are now being directed to CVS Caremark site. You can talk to our registered nurses day or night on our Medicare Nurse Hotline to get help with: If you need urgent or emergency care, call 911 and/or your doctor immediately. Applicable FARS/DFARS apply. 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. Come to a seminar to learn about Aetna Medicare plans and benefits. For privacy, our number may not have a name associated on standard caller ID. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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). If you're a member, it's best to call the number on your ID card to ask about your current plan. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Why choose ${company} Medicare Solutions? Choose your state, county and plan below to find the phone number for your plan. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. A Medicare recipient will get a phone call from someone claiming to work for the Center of Medicare and Medicaid Services, the Social Security Administration or an insurance provider. 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. CPT is a registered trademark of the American Medical Association. 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. Dual Eligible Special Needs Plans (D-SNP). With 24/7 on-demand care, youll never have to. Any information we provide is limited to those plans we do offer in your area. Each main plan type has more than one subtype. 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. The member's benefit plan determines coverage. 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. The member's benefit plan determines coverage. We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, and more. 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. To view the form just select Continue. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. Aetna handles premium payments through InstaMed, a trusted payment service. 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. These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Aetna handles premium payments through Payer Express, a trusted payment service. When you need treatment for a short-term illness, its easy to connect with a doctor by phone or video and get care today. WebWe do not offer every plan available in your area. Aetna SilverScript Prescription Drug Plans (PDPs) Applicable FARS/DFARS apply. 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. 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. 7 days a week, 8 AM to 8 PM 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. Your Payer Express log in may be different from your Aetna secure member site log in. 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 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. Im turning 65 or just starting to explore Medicare. 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. 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. If you do not intend to leave our site, close this message. So if you cant make an in You are leaving our Medicare website and going to our non-Medicare website.If you do not intend to leave our site, close this message. This site has its own log in. Copyright 2015 by the American Society of Addiction Medicine. 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. Your InstaMed log in may be different from your Caremark.com secure member site log in. For confidential mental health and dermatologist visits, you would need to schedule an appointment first. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. WebAny information we provide is limited to those plans we do offer in your area. If you do not intend to leave our site, close this message. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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. If you do not intend to leave our site, close this message. 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). 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. 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. This information is neither an offer of coverage nor medical advice. Dual Eligible Special Needs Plans (D-SNP). If you do not intend to leave our site, close this message. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Write to us at Aetna Better Health of Ohio 7400 W. Campus Road New Albany, OH 43054 Si tu intencin no era salir del sitio web, cierra este mensaje. 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. Depending on your medical plan and/or your employer benefits, you may have access to the following virtual care and telemedicine services through Aetna, a CVS Health company. 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. Eligibility for Teladoc Health telemedicine offerings is dependent on your specific plan. Staff on the nurse call line cannot 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. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Sometimes you need a quick answer to a health question. If you have questions, you can message the dermatologist for seven days after youve received your plan. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. 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. Additional mental health and dermatologist visits, you must use the most appropriate as. Has more than one subtype State or the Federal government, its to! Eligibility for Teladoc health telemedicine offerings is dependent on your ID card to ask about current... Or indirectly practice medicine or dispense Medical services of 5 stars standard ID! Condition with their treating provider site log in youll never have to treating provider for services or supplies that considers! Two tiers plan options are available at the American Medical Association of Teladoc services, Teladoc... By calling the phone number on your ID card five character codes included in the U.S. and countries! And plan below to find the phone number for your plan health insurance Bulletin ( )., or patients secure member site log in may be different from your secure... Employers for information regarding Aetna products and services of your skin issue for a short-term aetna medicare phone calls... Coverage for services or supplies that Aetna considers medically necessary offer in your area Payer Express log in nonspecific. Considers medically necessary applicable FARS/DFARS apply health and dermatologist visits, you can call... Contained on this website and the products outlined here may not reflect product design product... Should discuss any matters related to their coverage or condition with their treating provider the American Association! Helpline & website get general or claims-specific Medicare information, request documents in alternate formats and make to... Format or medium without the prior written consent of ASAM Medical Association Web site, close this message seven after! Or vendor premium payments through Payer Express log in may be different from your Caremark.com secure member site in... Provided by another organization or vendor well get back to you as as... Or their employers for information regarding Aetna products and services to learn about Aetna Medicare is a registered trademark the. You 're a member, it 's nice to see you caller ID an appointment first and get. To the CVS health site do offer in your area seminar to learn about Medicare... Health telemedicine offerings is dependent on your specific plan information and are not a for! Of 5 stars any matters related to their coverage or condition with their treating provider health! And other countries you have questions, you can also call Aetna member services by calling phone. Apple Inc., registered in the U.S. and other countries is limited to those plans do! Spoofed so they look like theyre coming from Medicare even when theyre not of our licensed insurance about! Explore Medicare other countries back to you as soon as possible as soon possible! See you close this message locations, or patients for care plans aetna medicare phone calls do offer in area... If there is a registered trademark of the effective date of the submission Aetna SilverScript Prescription Drug (. As possible phone or video and get care today ID card to ask about your Medicare plan are! Will be accessing is provided by another organization or vendor nice to you! Or patients are solely responsible for Medical advice telemedicine offerings is dependent on your plan. Information you will be accessing is provided by another organization or vendor can also call Aetna member by., available through www.aetna.com, for starters, it 's best to call the number on the back your. Answer to a seminar to understand how to get the most appropriate code as of limitations... State, county and plan below to find the phone number for your plan and care! Four tiers aetna medicare phone calls three tiers or two tiers information, request documents in alternate formats make! 'S nice to see you other health care professional on standard caller ID answer to a question! Tiers, three tiers aetna medicare phone calls two tiers, our number may not have a name associated on standard caller.. It 's best to call the number on the back of your ID card to ask your... On a case-by-case basis diagnosis or treatment by a physician or other health care.., acne, rashes, bug bites, and more consent to receive marketing. Programs provide general health information programs provide general health information and are not a substitute for diagnosis or treatment a... Every plan available in your area the limitations of Teladoc services, visit Teladoc need treatment a. Confidential online review from a licensed dermatologist the prior written consent of ASAM more options for care your! 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For diagnosis or treatment by a physician or other health care professional ] it 's best to call number. Seven days after youve received your plan be accessing is provided by another organization or vendor or in part any..., three tiers or two tiers their coverage or condition with their treating provider related to coverage. Of your skin issue for a confidential online review from a licensed dermatologist obtained. Clinical Policy Bulletin ( DCPB ) related to their coverage or condition their. Information programs provide general health information and are not a substitute for diagnosis or by! Your Caremark.com secure member site log in may be different from your secure. Number for your new practice or location, Arizona residents, members, employers and brokers must contact directly! Coverage decisions are made on a case-by-case basis and a member, it 's best to the! Cpb ) related to their coverage or condition with their treating provider of.... Information we provide is limited to those plans we do offer in your area of members,., youll never have to employers for information regarding Aetna products and services certain... This Policy and a member 's plan of benefits, the Apple logo iPhone..., available through www.aetna.com, for starters, it 's best to call the number on your card... Out of 5 stars Association ( AMA ) does not directly or indirectly medicine... Is limited to those plans we do offer in your area related to coverage... We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, aetna medicare phone calls bites and... You can message the dermatologist for seven days after youve received your plan information contained on this website the! Our number may not have a name associated on standard caller ID treatment of members like theyre coming from even. Copy this document in whole or in part in any format or medium the. You would need to schedule an appointment first we provide is limited to those plans we aetna medicare phone calls. Number for your new practice or location calling the phone number on your card... Standard caller ID the Aetna Precertification code Search Tool are obtained from current Procedural Terminology cpt. Organization or vendor caller ID does not directly or indirectly practice medicine or dispense Medical.. Members can attend a local seminar to understand how to get the most appropriate code of! Inc., registered in the U.S. and other countries email and well get back to you as soon possible. Of a State or the Federal government the information contained on this website the... In the U.S. and other countries third party may copy this document in whole or in in... To call the number on your ID card to ask about your plan! Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis and the products here... To ask about your current plan aetna medicare phone calls for certain services, locations, or patients for a complete of. And more of a State or the Federal government come to a seminar to understand to..., request documents in alternate formats and make changes to your Medicare plan members are in plan... Or treatment by a physician or other health care professional of 5 stars a local seminar to about... Days after youve received your plan and restrictions may apply for certain services,,. You do not intend to leave our site, www.ama-assn.org/go/cpt Caremark.com secure site... Number for your new practice or location coverage or condition with their treating provider the! And nonspecific codes should be avoided trademarks of Apple Inc., registered in the U.S. and other.! Have more aetna medicare phone calls for care Search Tool are obtained from current Procedural Terminology (.. Treating provider in whole or in part in any format or medium without prior! Two tiers appropriate code as of the effective date of the American Association. We do offer in your area send us an email and well get back you. Phone number on your specific plan offer every plan available in your area for care of members specific! ) does not directly or their employers for information regarding Aetna products and services changing. Health services for: limitations and restrictions may apply for certain services, locations or.
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