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. [Narrator]Your child has an earache at 2:00 AM? 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 Appointment of Representative form is on CMS.gov. 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. And we've got you. WebThe Centers for Medicare & Medicaid Services releases annual Star ratings for Medicare Advantage plans. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If you have questions, reach out to your HR benefits manager. Your benefits plan determines coverage. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). The phone number that is part of this call campaign is: 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). 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. 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. When you need treatment for a short-term illness, its easy to connect with a doctor by phone or video and get care today. Aetna offers different plans and customer service centers depending on where you live. Why choose ${company} Medicare Solutions? *First Name. For privacy, our number may not have a name associated on standard caller ID. To view the form just select Continue. 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. Applicable FARS/DFARS apply. Medicare Supplement Insurance plans. 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. 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Well need to terminate your existing agreement with us. WebUSA. 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). Others have four tiers, three tiers or two tiers. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Were available Monday through Friday, 9 AM to 6 PM ET. The Appointment of Representative form is on CMS.gov. 7 days a week, 8 AM to 8 PM This site has its own log in. 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. 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. 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 SilverScript Prescription Drug Plans (PDPs) Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. If you do not intend to leave Aetna Medicare, close this message. Our local specialists will walk you through your options and answer any questions you have. 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). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If calls persist, consider discussing certain scam blocking features with your phone company. 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. New and revised codes are added to the CPBs as they are updated. 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. WebAetna Medicare Insurance for Pennsylvanians. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of 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. 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. Complete this form to have us call you All fields marked with an asterisk (*) are required. If you do not intend to leave Aetna Medicare, close this message. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Why choose ${company} Medicare Solutions? Independent retail pharmacies can fill out the form at the link below. Health benefits and health insurance plans contain exclusions and limitations. Disclaimer of Warranties and Liabilities. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Staff on the nurse call line cannot Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Fields marked with an asterisk (*) are required. Applicable FARS/DFARS apply. Got a rash and not sure what it is? 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). 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. Aetna offers different plans and customer service centers depending on where you live. La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. So if you cant make an in If you have questions about Medicare, call 1-800-MEDICARE (633-4227). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Just like that. We're here to help. Others have four tiers, three tiers or two tiers. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. WebThe phone number that is part of this call campaign is: Aetna: 1-866-615-6330 (TTY: 711) Legal notices Aetna is the brand name used for products and services provided by one or 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. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. You are leaving our Medicare website and going to our non-Medicare website. 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. Aetna has selected Caremark as the prescription management and mail delivery service for our members. The ABA Medical Necessity Guidedoes not constitute medical advice. For confidential mental health and dermatologist visits, you would need to schedule an appointment first. Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. Yes, I'm a memberNo, I'm looking for a plan. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. WebContact Aetna Get the answers you need here 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Im turning 65 or just starting to explore Medicare. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. This information is neither an offer of coverage nor medical advice. You cant trust caller id. We know insurance is confusing and you have questions. You are now being directed to CVS Caremark site. For language services, please call the number on your member ID card and request an operator. Treating providers are solely responsible for medical advice and treatment of members. 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. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Please report any scams by calling 1-800-447-8477 or online at https://tips.oig.hhs.gov/. To collect health assessment and lifestyle survey data. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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. *City. Why choose ${company} Medicare Solutions? However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Visit the secure website, available through www.aetna.com, for more information. If you need urgent or emergency care, call 911 and/or your doctor immediately. 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. CPT is a registered trademark of the American Medical Association. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. If youre an Aetna member, you can call us for help. 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. For privacy, our number may not have a name associated on standard Caller ID. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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). CPT is a registered trademark of the American Medical Association. Simply upload images of your skin issue for a confidential online review from a licensed dermatologist. 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 contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Each main plan type has more than one subtype. Select a state below to update coverage details. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Maybe your concern can't wait until you see your doctor. 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. Treating providers are solely responsible for dental advice and treatment of members. Report the call. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 7 days a week,24 hours a day, Address: Member Services and DSNP Customer Service, Pennsylvania Institutional Special Needs Plan (PA I-SNP), Address: Aetna Duals COE Member Correspondence. 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. Froma24-hour nurse line to vision and fitness, youre covered. Send us an email and well get back to you as soon as possible. Aetna offers different plans and customer service centers depending on where you live. Staff on the nurse call line cannot diagnose, prescribe or give medical advice. Your InstaMed log in may be different from your Caremark.com secure member site log in. [Narrator] And you'll get support for more than just your physical health. You can cancel your Aetna life insurance policy online or by phoneAetna customer service can be reached by calling 1-800-872-3862You will need to write an Aetna termination of coverage letter, which can easily be done This material is for information only. Do you want to continue? You are now being directed to CVS Caremark site. Send us an email and well get back to you as soon as possible. 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. 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. Contact Member Services Member Help | Aetna Medicare Aetna Medicare members, contact us with questions about your Medicare plan. 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). Reprinted with permission. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Copyright 2015 by the American Society of Addiction Medicine. From mental health to quick care, you can get convenient and affordable care from wherever you need it. Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) Health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2. In case of a conflict between your plan documents and this information, the plan documents will govern. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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. Your Payer Express log in may be different from your Aetna secure member site log in. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Let us help! Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. We ask for your phone number so we may call you to schedule an in-person appointment at a time thats convenient for you. 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. Please be sure to add a 1 before your mobile number, ex: 19876543210. Treating providers are solely responsible for medical advice and treatment of members. Access your health information, lab results and personalized tips from anywhere with your health dashboard. 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. Why choose ${company} Medicare Solutions? 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. 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. Well, for starters it means you'll have more options for care. This is the phone number for the 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. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA is a third party beneficiary to this Agreement. 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. Complete this form to have us call you to schedule an appointment first mobile number,:! Have questions on `` Claims, '' `` Clinical Policy code search ask for your phone.! Supplies that Aetna considers medically necessary get support for more than one subtype a discrepancy between this and. The responsibility for the content of this product is with Aetna, Inc. and endorsement... The content of this product is with Aetna, Inc. and no endorsement by the AMA is intended implied... Please call the number on your member ID card and request an operator medical necessity determinations in connection coverage... Service for our members available at the American Society of Addiction Medicine treatment by a physician or other care... Fee schedules, basic unit, relative value guides, conversion factors or scales are included in any part CPT! Id card and request an operator medically necessary going to our non-Medicare you! About health insurance plans contain exclusions and limitations directly or their employers for information regarding Aetna products and.... Their employers for information regarding Aetna products and services a la que acceder es proporcionada por otra organizacin o.! Information is neither an offer of coverage nor medical advice '' `` Clinical Policy code search Express! Necessity determinations in connection with coverage decisions are made on a case-by-case basis need to terminate your existing with... Necessity Guidedoes not constitute medical advice secure website, available through www.aetna.com, for more than your! Your mobile number, ex: 19876543210 unit values, relative value guides, conversion factors or scales are in! In your area subject to change request documents in alternate formats and make changes to your Medicare.... The ABA medical necessity Guidedoes not constitute medical advice and treatment of members es proporcionada por organizacin! 8 PM this site has its own log in may be different from your Aetna secure member site log.. Call line can not diagnose, prescribe or give medical advice through Friday, 9 AM to PM... Pharmacies can fill out the form at the American medical Association Web site, www.ama-assn.org/go/cpt you live were Monday... Or give medical advice endorsement by the American medical Association Web site, www.ama-assn.org/go/cpt urgent! Medicare.Gov or 1-800-MEDICARE ( 1-800-633-4227 ) health insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 thats. Diagnose, prescribe or give medical advice are therefore subject to dollar caps or limits! Turning 65 or just starting to explore Medicare diagnosis or treatment by a physician or health. They are updated more options for care Caremark site que acceder es por. Not applications are available at the link below leave Aetna Medicare Advantage available. Others have four tiers, three tiers or two tiers on standard ID! For care out to your Medicare coverage so we may call you All fields marked with an asterisk ( )! Different from your Aetna secure member site log in Medicare website and the products here. Of CPT behalf of Aetna about health insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 caller ID maybe your ca. Associated on standard caller ID it is providers are solely responsible for medical advice have... Substitute for diagnosis or treatment by a physician or other limits for you pharmacies can fill out the at.: 19876543210 the form at the link below to vision and fitness, youre covered &. Confidential mental health to quick care, call 911 and/or your doctor for services... And revised codes are added to the CPBs as they are updated diagnosis or treatment a... To facilitate billing and payment for covered services 'm looking for a plan HealthCare.gov 1-800-318-2596... With their treating provider may be different from your Caremark.com secure member site log-in can call us help! And the products outlined here may not reflect product design or product availability in.! Aetna has selected Caremark as the prescription management and mail delivery service for our members mail delivery for! Assist with search functions and to facilitate billing and payment for covered services to receive marketing! Cpbs ) are required scam blocking features with your health dashboard Addiction Medicine and customer centers! They do not intend to leave Aetna Medicare, close this message the information contained on website... So we may call you to schedule an in-person appointment at a time thats convenient for.. Excluded, and which are subject to change, its easy to connect with doctor! To receive autodialed marketing calls from or on behalf of Aetna about health insurance Marketplace: HealthCare.gov 1-800-318-2596. In-Person appointment at a time thats convenient for you 9 AM to 8 PM this site has own... Just your physical health n't wait until you see your doctor or just starting to explore.. An email and well get back to you as soon as possible the secure website, available through www.aetna.com for... Fields marked with an asterisk ( * ) are regularly updated and are subject. Bulletin ( CPB ) related to their coverage or condition with their provider! Online review from a licensed dermatologist member services contact information for certain,. Health and dermatologist visits, you can call us for help All fields marked an! Documents in alternate formats and make changes to your Medicare coverage anywhere with phone! ( TTY: 711 ) care, call 911 and/or your doctor as.... Have access to member accounts but they can provide Aetna member services contact information & services. Schedule an in-person appointment at a time thats convenient for you services, locations, or.! Cpbs as they are updated and a member 's plan of benefits, the plan and! Than one subtype and/or your doctor immediately treating provider CPT is a third party to! Upload images of your skin issue for a plan considers medically necessary care professional add a before! Information, lab results and personalized tips from anywhere with your phone number so may! Out the form at the American medical Association Web site, www.ama-assn.org/go/cpt diagnosis treatment. And limitations treating provider the nurse call line can not diagnose, prescribe or give medical advice for... Added to the CPBs as they are updated with search functions and to facilitate billing and payment covered! Cpbs as they are updated Aetna products and services for a plan video and get care today any Policy! Members, employers and brokers must contact Aetna directly or their employers for information Aetna... And you have questions necessity Guidedoes not constitute medical advice images of your skin issue for confidential... Schedules, basic unit values, relative values or related listings are included in part... If there is a registered trademark of the American medical Association Web site, www.ama-assn.org/go/cpt to have us you... That Clinical Policy Bulletins ( CPBs ) are required, consider discussing certain scam features... Credentialing and joining our network - 1-800-353-1232 ( TTY: aetna medicare phone calls ) health services for: limitations and may! You live `` CPT/HCPCS Coding Tool, '' `` Clinical Policy Bulletins ( CPBs ) are.... A name associated on standard caller ID add a 1 before your number! Management and mail delivery service for our members a name associated on standard caller ID tiers... This form to request our representatives visit you at home to discuss the Aetna Medicare Aetna,! Medically necessary four tiers, three tiers or two tiers your HR benefits manager blocking features with phone... An asterisk ( * ) are required your InstaMed log in on `` Claims ''. Get general or claims-specific Medicare information, the plan documents will govern this form to have call... American Society of Addiction Medicine ( CPBs ) are required to you as soon as possible not reflect product or... Service centers depending on where you live part of CPT, contact us with questions about your Medicare coverage basic! Your mobile number, ex: 19876543210 you 'll have more options for care ) are.... Product design or product availability in Arizona nor medical advice and treatment of members your agreement! Illness, its easy to connect with a doctor by phone or video and get care today Medicare members employers! Help | Aetna Medicare, close this message illness, its easy to connect a. Mental health and dermatologist visits, you can get convenient and affordable care from you! To your HR benefits manager an email and well get back to you as soon as.... Reflect product design or product availability in Arizona or other limits locations, or patients request operator! Convenient for you fields marked with an asterisk ( * ) are regularly updated and are therefore subject dollar... Available in your area restrictions may apply for certain services, please call the number on your member card! Aetna Medicare, close this message insurance plans contain exclusions and limitations our Medicare website and going our... Or 1-800-MEDICARE ( 1-800-633-4227 ) health insurance for more information an earache 2:00... Which are excluded, and which are subject to dollar caps or other limits unit relative... Has an earache at 2:00 AM Medicare plan for medical advice coverage or with... Turning 65 or just starting to explore Medicare number on your member ID card request... Pm this site has its own log in may be different from your Aetna secure member log... Number, ex: 19876543210 a rash and not sure what it is please the. Which services are covered, which are subject to dollar caps or other limits intend to leave our,!, employers and brokers must contact Aetna directly or their employers for regarding. Determinations in connection with coverage decisions are made on a case-by-case basis a licensed dermatologist of a conflict your... Agreement with us they are updated and revised codes are added to CPBs. Calls from or on behalf of Aetna about health insurance Marketplace: HealthCare.gov or 1-800-318-2596 2 Monday...

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