aetna claims mailing address

Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. New and revised codes are added to the CPBs as they are updated. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. This information is neither an offer of coverage nor medical advice. 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. PO Box 981106 You have options. Treating providers are solely responsible for dental advice and treatment of members. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. 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). All the contents and articles are based on our search and taken from various resources and our knowledge in Medical billing. 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. 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. Due to current market conditions, actual product. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Medical Billing and Coding Information Guide. No contract is required to see members enrolled in these plans. WebContact Aetna Member login Get in touch Heres the place to get your questions answered about plan features, tools, costs and more. Applicable FARS/DFARS apply. 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.) Treating providers are solely responsible for medical advice and treatment of members. This search will use the five-tier subtype. Members should discuss any matters related to their coverage or condition with their treating provider. Treating providers are solely responsible for medical advice and treatment of members. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies. All providers, both participating and nonparticipating, can submit claims electronically regardless of patients benefits plan. This section relates to information about the covered person. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. ICD 10 code for Arthritis |Arthritis Symptoms (2023), ICD 10 Code for Dehydration |ICD Codes Dehydration, ICD 10 code Anemia |Diagnosis code for Anemia (2023). Disclaimer of Warranties and Liabilities. WebForms and Resources. No referrals are required to see members enrolled in these plans. Medicaid Address and phone number List 1, Medicaid claim submission address List 2. Have questions about our products, policies and services? Links to various non-Aetna sites are provided for your convenience only. 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. Reprinted with permission. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Aetna Signature Administrators800-238-6288CoverMyMeds866-452-5017Coventry (workers comp and no-fault auto injury)800-937-6824Aetna medicare supplement claims addressAetna Senior Supplemental Insurance P.O. 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. A Google Certified Publishing Partner. Dont have an account? Submit all paper claims for covered services as soon as possible using an Aetna No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. You are now being directed to CVS Caremark site. Aetna Medicare Grievance & Appeals Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 BOX 14586 Applicable FARS/DFARS apply. 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. 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. 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. Avoid the additional cost of submitting duplicate claims by using the Claim Status Inquiry to check the status of claims prior to resubmitting. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Call Aetna Mail Order Drug at 1-866-612-3862 (TTY: 711). In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. ICD 10 Code for Obesity| What is Obesity ? PO Box 14579 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. The ABA Medical Necessity Guidedoes not constitute medical advice. The member's benefit plan determines coverage. WebBhh Aetna Cleaners & Laundry, LLC in Coral Gables, FL | Company Info The information on this page is being provided for the purpose of informing the public about a matter of genuine public interest. As a result, you are likely to see more patients with these health plans. Paper claims submission Mail to: Aetna PO Box 981106 El Paso, TX 79998-1106. For your convenience, we recommend that you add your Member Services number to your phone contacts. All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. Reimbursement and claims processing information. Members should discuss any matters related to their coverage or condition with their treating provider. Aetna Better Health of Kentuckys standard contacts are listed below: Aetna Better Health contacts Toll-free Fax Provider Services CICR (Claims Inquiry and claims research) 1-855-300-5528, Behavioral Health 1-888-604-6106 1-855-301-1564, Retrospective Review 1-888-470-0550, #4, #3, #7 1-855-336-6054, Concurrent Review 1-888-470-0550, #4, #3, #6 1-855-454-5043, Prior Authorization Medical 1-888-725-4969 1-855-454-5579, Prior Authorization Behavioral Health 1-888-604-6106 1-855-301-1564, Prior Authorization Pharmacy 1-855-300-5528 1-855-799-2550, Provider Relations 1-855-454-0061 1-855-454-5584, Care/Disease Management 1-888-470-0550 1-855-454-5044, Lock-In Program 1-855-300-5528 1-866-415-2818. Tampa Florida 33630 CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Please log in to your secure account to get what you need. Copyright 2015 by the American Society of Addiction Medicine. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. But for those enrolling in an HMO plan, this is especially important. Mail to: 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. Applicable FARS/DFARS apply. P.O. Paper claims submission 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. The information you will be accessing is provided by another organization or vendor. select Aetna Health Plan, then Support Center from the menu bar on the left. You are now being directed to the CVS Health site. Others have four tiers, three tiers or two tiers. License to use 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. I practice independently and I want to contract with Aetna. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. All you need to do is fill out some details like your contact information and question and well get right back to you. 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. Unlisted, unspecified and nonspecific codes should be avoided. A. 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. Aetna Aetna has more address but usually accept all the claims whatever address you submit from the below list. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. Treating providers are solely responsible for medical advice and treatment of members. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. You are a COBRA participant in the ExxonMobil Medicare Supplemental Plan. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. To help us direct your question or comment to the correct area, please select a category below. MA, MD, ME, MI, MN, MO, MT, NE, Attachments arent necessary. No fee schedules, basic unit, relative values or related listings are included in CPT. In all cases, the patient or authorized person must sign. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). 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. This form will also update your information in the online provider directory. Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Multiple bills for each family member can be submitted with one claim form. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. AL, AK, AR, AZ, CA, FL, GA, HI, ID, LA, MS, NC, NM, NV, OR, SC, UT, TN, WA, State 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. With respect to bundling/unbundling logic, we use the Correct Coding Initiative (NCCI). 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. All Rights Reserved to AMA. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept".

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