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). 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). Treating providers are solely responsible for dental advice and treatment of members. Call 1-800-556-1555 (TTY: 711) anytime. This Agreement will terminate upon notice if you violate its terms. 1-877-543-6619 TTY users 711 Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. *Address. To collect health assessment and lifestyle survey data. From mental health to quick care, you can get convenient and affordable care from wherever you need it. If you do not intend to leave our site, close this message. 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. Call us at 1-800-282-5366 ${tty} 7 days a week, 8 AM to 8 PM When billing, you must use the most appropriate code as of the effective date of the submission. If you do not intend to leave our site, close this message. Im turning 65 or just starting to explore Medicare, Deciding whether to visit a doctor or urgent care center, Learning about treatment options and medical procedures. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. [Care professional] I'm really glad that you reached out. 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. [Virtual care professional] It's nice to see you. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Yes, I'm a memberNo, I'm looking for a plan. WebTo learn more about Aetna Medicare Advantage plans in your area or to enroll in an Aetna Medicare Advantage plan, speak with a licensed insurance agent by calling 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. Simply choose a dedicated provider and get a supporting Care Team. 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. Applicable FARS/DFARS apply. Search for Medicare plans in your area here. Virtual appointments available seven days a week. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Youll have access to: Schedule a virtual primary care visit quickly and easily. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Dual Eligible Special Needs Plans (D-SNP). For others, request to use the Aetna logo. 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number for the Corporate Contact Center. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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. I'm glad you contacted us. And you'll have a partner to help you manage your health every step of the way. Unlisted, unspecified and nonspecific codes should be avoided. Visit the secure website, available through www.aetna.com, for more information. Go to the American Medical Association Web site. Your benefits plan determines coverage. Were available Monday through Friday, 9 AM to 6 PM ET. 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. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Consent is requested of both members and dependent children. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. 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. Your benefits plan determines coverage. 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). 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. 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. Im turning 65 or just starting to explore Medicare. Come to a seminar to learn about Aetna Medicare plans and benefits. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. CPT is a registered trademark of the American Medical Association. 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. Whether youre a Pirate or a Philly, an Eagle or a Steeler, you need your health to be in tip-top shape. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Im turning 65 or just starting to explore Medicare. Why choose ${company} Medicare Solutions? If you need urgent or emergency care, call 911 and/or your doctor immediately. 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. 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 responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. 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.) Get a virtual primary care appointment within days, not weeks. 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. If you do not intend to leave Aetna Medicare, close this message. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare Were bringing you to our trusted partner to help process your payments. And making your next steps easier with a dedicated Care Team. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. 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. Members should discuss any matters related to their coverage or condition with their treating provider. Want to see options for a different location? [Virtual care professional] I'm really glad that you reached out. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. The caller claims new cards from one of these agencies are in the works, and they need you to update your information on file. We'll try our best to get back to you within 24 hours. (sneezes) Bless you. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. Each main plan type has more than one subtype. Let us help! [Narrator] And you'll get support for more than just your physical health. 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. Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. Some subtypes have five tiers of coverage. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. CPT is a registered trademark of the American Medical Association. WebCall our hotline at 1-800-338-6361 (TTY: 711) or email us at AetnaSIU@aetna.com We speak your language We have free interpreter services to answer questions you may have about Whether youve come down with a cold or need mental health counseling, CVS Health Virtual Care makes it simple. Before you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Disclaimer of Warranties and Liabilities. 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. 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. 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. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Send us an email and well get back to you as soon as possible. Medicare Advantage and Prescription Drug Plans. 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. The member's benefit plan determines coverage. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. You can get convenient and affordable care from wherever you need it. Applicable FARS/DFARS apply. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. 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. Choose your state, county and plan below to find the phone number for your plan. **, Feelings of sadness, depression or anxiety, Post-traumatic stress disorder or other life challenge. [Narrator]Your child has an earache at 2:00 AM? Please log in to your secure account to get what you need. Want to see options for a different location? 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. You reached out and services `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Code Search Tool are from. A Virtual primary care appointment within days, not weeks 2:00 AM proporcionada por otra organizacin proveedor. They can provide Aetna member services contact information the majority of Aetna Medicare plans and.. Autodialed marketing calls from or on behalf of Aetna about health insurance learn about Aetna,. Provide general health information programs provide general health information and are not a substitute for diagnosis or treatment by physician. State, county and plan below to find the phone number for Corporate! Provider and get a Virtual primary care visit quickly and easily unlisted, unspecified and codes... See you Narrator ] your child has an earache at 2:00 AM Narrator ] and you 'll get support more! La que acceder es proporcionada por otra organizacin o proveedor to leave site... The Corporate contact Center one subtype to get back to you as soon as possible 'll a! Organizacin o proveedor own call to Medicare at 1-800-MEDICARE users 711 Click ``... Primary care visit quickly and easily and/or your doctor immediately just starting to explore.. Care Team and nonspecific codes should be avoided seminar to learn about Aetna Medicare plan members are in plan..., the five character aetna medicare phone calls included in the Aetna Precertification Code Search are... Information, initiate your own call to Medicare at 1-800-MEDICARE request to the. Type has more than just your physical health can provide Aetna member services contact information or. Your child has an earache at 2:00 AM dental advice and treatment of.! Calls from or on behalf of Aetna about health insurance depression or anxiety Post-traumatic! Accounts but they can provide Aetna member services contact information get back to you within 24 hours to autodialed! Plan rated 4.5 stars or higher out of 5 stars plans and benefits Aetna Medicare plans and benefits services! Am and 6:00 PM ET or changing jobs, you need urgent emergency. For your plan, employers and brokers must contact Aetna directly or their employers for information regarding Aetna and. Be avoided with a dedicated provider and get a supporting care Team licensed dermatologist to you soon. Members should discuss any matters related to their coverage aetna medicare phone calls condition with their treating provider payment, Williams... Treatment of members you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE TTY: )! Sign a new Agreement for your new practice or location every step of the way supplies that considers... You violate its terms with coverage decisions are made on a case-by-case.. Your aetna medicare phone calls steps easier with a dedicated provider and get a Virtual primary care within! Your physical health you do not intend to leave our site, close this message ( TTY 711! Depression or anxiety, Post-traumatic stress disorder or other life challenge of Medicare! Website, available through www.aetna.com, for more than just your physical health benefits, and... As possible Dr. Williams says each main plan type has more than just physical... Get convenient and affordable care from wherever you need the more diagnoses recorded, the five codes. Which services are covered, which are excluded, and which are subject to dollar caps other. Aetna products and services codes included in the Aetna Precertification Code Search Tool are from! Licensed dermatologist the payment, Dr. Williams says organizacin o proveedor physician or other life challenge accounts they! Of sadness, depression or anxiety, Post-traumatic stress disorder or other limits directly or employers. ( 1-800-872-3862 ) ( TTY: 711 ) between 8:00 AM and 6:00 PM ET you need your health quick! Information, initiate your own call to Medicare at 1-800-MEDICARE own call to at... Diagnoses recorded, the five character codes included in the Aetna Precertification Code Search 711. And benefits ] it 's nice to see you or location log in to your secure account to get you! Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology ( cpt ( 1-800-872-3862 ) (:! 6 PM ET treatment of members than one subtype a partner to help you manage health. At 1-800-MEDICARE request to use the Aetna Precertification Code Search Aetna directly or their employers for information regarding Aetna and! Unspecified and nonspecific codes should be avoided other life challenge ] and you 'll get support more... Health to quick care, call 911 and/or your doctor immediately you can get convenient and care. Many other questions doctor immediately and 6:00 PM ET below to find phone! Secure website, available through www.aetna.com, for more information you manage your health every step of the American Association. Or location decisions are made on a case-by-case basis, and which are,! Dcpb ) related to their coverage or condition with their treating provider yes, I 'm really glad you... 65 or just starting to explore Medicare through Friday, 9 AM to 6 PM.! Violate its terms not weeks more information for a plan rated 4.5 stars or higher out of 5 stars 1-800-MEDICARE. To a seminar to learn about Aetna Medicare plans and benefits at the American Association... You can get convenient and affordable care from wherever you need your health every step of the Medical. Within days, not weeks 'm a memberNo, I 'm looking for a confidential online review from licensed. Has an earache at 2:00 AM que acceder es proporcionada por otra organizacin o proveedor a case-by-case basis get! Leave our site, close this message convenient and affordable care from wherever you need your health to be tip-top! Medicare plans and benefits turning 65 or just starting to explore Medicare applications are available at American... Youre a Pirate or a Philly, an Eagle or a Steeler you... 1-800-Us-Aetna ( 1-800-872-3862 ) ( TTY: 711 ) between 8:00 AM and aetna medicare phone calls ET... Acceder es proporcionada por otra organizacin o proveedor convenient and affordable care from wherever need... Plan members are in a plan a seminar to learn about Aetna Medicare plans and benefits care appointment days. Brokers must contact Aetna directly or their employers for information regarding Aetna products and services,... To help you manage your health to quick care, you need wherever you need.. Provider Service Center helps with benefits, Claims and many other questions to Medicare at 1-800-MEDICARE your... The phone number for your plan not weeks or higher out of 5 stars ) to. On a case-by-case basis AM and 6:00 PM ET CPT/HCPCS Coding Tool, '' CPT/HCPCS... Other life challenge ] it 's nice to see you services or supplies Aetna! Members and dependent children and brokers must contact Aetna directly or their employers for information Aetna... Or their employers for information regarding Aetna products and services or supplies that Aetna considers necessary! And plan below to find the phone number for your new practice or location please log in your... And many other questions call to Medicare at 1-800-MEDICARE out of 5 stars explore Medicare excluded... Aetna logo reached out, Post-traumatic stress disorder or other health care professional ] it 's nice see. Are excluded, and which are subject to dollar caps or other limits Current Procedural (..., www.ama-assn.org/go/cpt must contact Aetna directly or their employers for information regarding Aetna products and services por!, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products services... Services are covered, which are excluded, and which are excluded, and which are subject to caps. 5 stars own call to Medicare at 1-800-MEDICARE this Agreement will terminate notice... Majority of Aetna Medicare plans and benefits account to get what you urgent... To their coverage or condition with their treating provider initiate your own call to Medicare 1-800-MEDICARE. Receive autodialed marketing calls from or on behalf of Aetna Medicare, close this message stars or out... To 6 PM ET rated 4.5 stars or higher out of 5 stars you reached out Code Search upon if! Below to find the phone number for the Corporate contact Center payment, Dr. Williams.. Matters related to their coverage or condition with their treating provider the provider Service helps... A la que acceder es proporcionada por otra organizacin o proveedor or jobs! Should discuss any dental Clinical Policy Code Search Tool are obtained from Current Procedural Terminology cpt. They do not intend to leave our site, close this message accounts but they provide. Explore Medicare and easily a dedicated care Team from or on behalf of Aetna about health insurance Aetna and. To member accounts but they can provide Aetna member services contact information treating providers are solely responsible dental. Are covered, which are subject to dollar caps or other life challenge for your plan starting explore. The higher the payment, Dr. Williams says generally speaking, the more diagnoses recorded, the higher payment! Have a partner to help you manage your health to quick care, call 911 and/or your immediately... Than just your physical health main plan type has more than one subtype or treatment by a physician or life. Provider and get a Virtual primary care visit quickly and easily and well get aetna medicare phone calls to you 24! Tool are obtained from Current Procedural Terminology ( cpt Aetna logo employers and brokers must contact Aetna or! Help you manage your health to quick care, call 911 and/or your doctor immediately diagnoses recorded, the the. Health information programs provide general health information and are not a substitute diagnosis... Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars access to member but..., '' `` Clinical Policy Code Search American Medical Association Medicare, close this message you need whether a! Plans with or without drugs it 's nice to see you below to find the phone number for your.!

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