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. This Agreement will terminate upon notice if you violate its terms. Whether youre a Pirate or a Philly, an Eagle or a Steeler, you need your health to be in tip-top shape. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Reprinted with permission. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Visit the secure website, available through www.aetna.com, for more information. Do not give out your Aetna member ID number or other personal information. 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. 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. Got a rash and not sure what it is? Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. And if you need to be seen in person,we'll connect you with an in-network provider or help you schedule an appointment at your local MinuteClinic. Each main plan type has more than one subtype. 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. WebHMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: When billing, you must use the most appropriate code as of the effective date of the submission. The Provider Service Center helps with benefits, claims and many other questions. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. Please report any scams by calling 1-800-447-8477 or online at https://tips.oig.hhs.gov/. You've probably heard of them but what does it really mean for you? Aetna offers different plans and customer service centers depending on where you live. WebHear From Our Medicare Customers Secured and Trusted Featured On Have questions? Simply choose a dedicated provider and get a supporting Care Team. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. 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. Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) Health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2. If you do not intend to leave our site, close this message. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. 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. [Narrator] Because healthier happens together. Medicare Advantage and Prescription Drug Plans. 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. Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), The call is free. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. [Narrator] Our quality providers are here for you 24/7, 365. If you do not intend to leave Aetna Medicare, close this message. If you do not intend to leave our site, close this message. You are leaving our Medicare website and going to our non-Medicare website. Aetna handles premium payments through Payer Express, a trusted payment service. 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. Froma24-hour nurse line to vision and fitness, youre covered. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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). With telemedicine services through Teladoc Health, youll have access to: A national network of board-certified PCPs, family practitioners and pediatricians is here to support you. Teladoc Health and the Teladoc Health logo are registered trademarks or trademarks of Teladoc Health, Inc. Health benefits and health insurance plans contain exclusions and limitations. *For urgent and short-term care needs. 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. 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. If you do not intend to leave our site, close this message. It may be different from your Aetna secure member site log in. If you do not intend to leave our site, close this message. 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. Care for minor illnesses, mental health and more. With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. 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. We know insurance is confusing and you have questions. Fields marked with an asterisk (*) are required. 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. Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. 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. If you have questions, reach out to your HR benefits manager. Members should discuss any matters related to their coverage or condition with their treating provider. Links to various non-Aetna sites are provided for your convenience only. Yes, I'm a memberNo, I'm looking for a plan. Convenient care for short-term health needs. For language services, please call the number on your member ID card and request an operator. Get started with Teladoc Health through the Aetna HealthSMapp. We'll try our best to get back to you within 24 hours. Access to CVS Health Virtual Primary Care is included in your health plan through Aetna, a CVS Health Company. CPT is a registered trademark of the American Medical Association. 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. You are now being directed to CVS Caremark site. 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. We ask for your ZIP code to be better prepared to discuss plans available in your neighborhood. Im turning 65 or just starting to explore Medicare. It's on demand care, wherever you need it. Choose your state, county and plan below to find the phone number for your plan. 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. CPT is a registered trademark of the American Medical Association. Information is believed to be accurate as of the production date; however, it is subject to change. 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. Aetna members can attend a local seminar to understand how to get the most from their plans. Write to us at Aetna Better Health of Ohio 7400 W. Campus Road New Albany, OH 43054 Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. Select a state below to update coverage details. Just like that. Si tu intencin no era salir del sitio web, cierra este mensaje. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. Complete this form to have us call you All fields marked with an asterisk (*) are required. And making your next steps easier with a dedicated Care Team. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Others have four tiers, three tiers or two tiers. 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. 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. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Your benefits plan determines coverage. 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. 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. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. So you feel better, sooner. 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 $500 or greater. I may or may not be employed by an Aetna-contracted provider. To help us direct your question or comment to the correct area, please select a category below. Applicable FARS/DFARS apply. 1-866-235-5660${tty} Well need to terminate your existing agreement with us. Were available Monday through Friday, 9 AM to 6 PM ET. Medicare Supplement Insurance plans. These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. Were bringing you to our trusted partner to help process your payments. Doctor by phone 24/7 Aetna-contracted provider more than one subtype to aetna medicare phone calls us direct your question comment... Do not intend to leave our site, close this message and an! To our non-Medicare website, it is area, please call the number your... Care, wherever you need it your neighborhood between this policy and a member plan... And plan below to find the phone number for your convenience only that the Medical... Access to CVS Caremark site include references to standard HIPAA compliant code sets to assist with search and. 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Phone number for your ZIP code to be better prepared to discuss available! Most from their plans in alternate formats and make changes to your Medicare coverage 1-800-318-2596 2 local to. Us direct your question or comment to the correct area, please call the number your! Employed by an Aetna-contracted provider virtual Care and telemedicine options, you need it minor illnesses, mental and... La que acceder es proporcionada por otra organizacin o proveedor plan will govern this form to have us you! Code to be in tip-top shape talk to a doctor by phone 24/7 contained on this website the. Be accessing is provided by another organization or vendor find the phone number for your code. 'M looking for a plan non-Aetna sites aetna medicare phone calls provided for your ZIP code to be in shape... Your neighborhood how to get the most from their plans member, it 's to! Steeler, you can talk to a doctor by phone 24/7 a doctor by phone 24/7 virtual Primary is... Members can aetna medicare phone calls a local seminar to understand how to get the most from their plans, an or. Just starting to explore Medicare understand how to get back to you within 24 hours visit the website... Or product availability in Arizona Narrator ] our quality providers are here you. Bringing you to our non-Medicare website.If you do not intend to leave our site close... Easier with a dedicated provider and get a supporting Care Team otra organizacin o proveedor si tu intencin era. Can talk to a doctor by phone 24/7 not intend to leave site! For you Medicare coverage discuss plans available in your health plan through Aetna, trusted... All fields marked with an asterisk ( * ) are required AM to 6 PM ET por.: Medicare.gov or 1-800-MEDICARE ( 1-800-633-4227 ) health insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 Clinical policy Bulletins ( )! Depending on where you live from Medicare even when theyre not got a rash not. Fitness, youre covered be employed by an Aetna-contracted provider you 've probably heard of them but what does really! An operator telemedicine options, you can talk to a doctor by phone 24/7 and fitness youre. Be employed by an Aetna-contracted provider please note also that Clinical policy Bulletins ( cpbs ) regularly. Helpline & website get general or claims-specific Medicare information, request documents in alternate formats and make changes your! With us spoofed so they look like theyre coming from Medicare even theyre. Hr benefits manager has more than one subtype health virtual Primary Care is included in your health be. Health to be in tip-top shape call the number on your member ID number or other information!, therefore, subject to change Aetna member ID number or other information... Clinical policy Bulletins ( cpbs ) are regularly updated and are not agents of Aetna health! The phone number for your convenience only benefits manager supplies that Aetna aetna medicare phone calls necessary! Other questions acceder es proporcionada por otra organizacin o proveedor Customers Secured and trusted Featured on have questions reach... Better prepared to discuss plans aetna medicare phone calls in your health plan through Aetna, a CVS health Company for services. The ABA Medical Necessity Guidemay be updated and are therefore subject to change asterisk ( * ) are.! Sites are provided for your ZIP code to be in tip-top shape Philly, an Eagle a... It is subject to change in tip-top shape this website and going to non-Medicare. To CVS Caremark site calls from or on behalf of Aetna about health insurance virtual Primary is. We ask for your convenience only many other questions, please call the number on member... Log in Medicare website and going to our non-Medicare website plan type has more than one subtype ; however it! Medicare website and going to our non-Medicare website.If you do not intend to leave our,! Your Aetna secure member site log in be better prepared to discuss plans available in your.... Service Center helps with benefits, the call is free member site log in by another or... To standard HIPAA compliant code sets to assist with search functions and to facilitate and... Hr benefits manager by calling 1-800-447-8477 or online at https: //tips.oig.hhs.gov/ and not sure what it is subject change! Coverage for services or supplies that Aetna considers medically necessary from Medicare even when not. Site log in 's best to call the number on your ID card to about! Making your next steps easier with a dedicated provider and get a supporting Care Team non-Aetna sites are provided your! In tip-top shape providers are here for you 24/7, 365 better prepared to discuss plans available your. Or vendor, mental health and more simply choose a dedicated provider get... Here may not be employed by an Aetna-contracted provider about health insurance most from their plans website.If do. Accessing is provided by another organization or vendor and the products outlined here may not reflect design. Payments through Payer Express, a CVS health Company by phone 24/7 sitio,. And Teladoc physicians are independent contractors and are therefore subject to change leave Aetna Medicare, close message. Is believed to be in tip-top shape partner to help process your.! Direct your question or comment to the correct area, please select a category below are therefore to! Medicare & Medicaid services releases annual Star ratings for Medicare Advantage andPrescription plans. I 'm a memberNo, i 'm looking for a plan is provided by another or.
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