7, 2021. 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. When billing, you must use the most appropriate code as of the effective date of the submission. You are now being directed to CVS Caremark site. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. Aetna is required to validate each participating provider's demographic information and certain other information that is displayed in our online provider directory. Make sure that eligibility details match the patients information. The information you will be accessing is provided by another organization or vendor. Wiki User. This information is neither an offer of coverage nor medical advice. Aetna Medical Insurance Policy Number. This is the phone number for the Corporate Contact Center. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. While its a good idea to verify patient eligibility at the beginning of the year, its best to verify their eligibility before every visit. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Aetna DMO and PPO grievance and appeals. In the event you have numerous cars, you may possibly have your entire cars recorded on a single card, or else you also may possibly have an alternative number or card to get every single motor vehicle. 3991. Call us. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Apply for an NPI online. (you might need to provide some information to confirm your identity), your billing information (if the question is about a bill). You can use this number to verify coverage, request an authorization/precertification, issue referrals and submit claims. Aetna Inc. 151 Farmington Avenue. The Plan ID is a 3-digit number that designates one plan from another for the IRS and DOL. All dental Medicare claims . It is only a partial, general description of plan or program benefits and does not constitute a contract. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 2021 Health-insurance-info.net. 9 hours ago 1-800-US- AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. INS CORPORATION OF AMERICA ( ICA ) 9065. Call a licensed agent at 1-855-335-1407 (TTY: 711) , 7 days a week, 8 AM to 8 PM. Companies Officers Log in/Sign up; AETNA REALTY COMPANY Company Number 0158346 Previous Company Numbers. Resources. Box 10462 Van Nuys, CA 91410 Provider Manuals. The company does offer Medicare Advantage plans (HMO, PPO, and POS) and Medicare Supplements to eligible seniors. 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. Example Policy Number: CAA012345678. These plans provide coverage for you, your spouse or partner and your dependent children. Sunday, Oct. 30, 2022. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. address/zip code/email/etc. 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. Log in or register. What is the policy number on an Aetna insurance card? In the , 5 hours ago Aetna Medical and Behavioral health: 888-632-3862: Coventry (Including workers compensation and auto injury) Aetna Life Insurance (California) 800-523-5065: , 6 hours ago Address, phone number, and practice changes Contact us online Contact us by phone For non-participating health care professionals Network applications (behavioral health, dental, , 8 hours ago What is policy number on health insurance card? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. What's New/Provider Bulletins. Where can I find my Aetna number? Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. New and revised codes are added to the CPBs as they are updated. As you can see, there isn't a standard type of auto insurance policy number. This is called group term insurance or group coverage. 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. Provider Pre-Authorization Tool. 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. 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. In all states but Florida and Minnesota, it is offered as a supplementary medical plan, not a Medicare plan. Unlisted, unspecified and nonspecific codes should be avoided. Please enter required fields to verify eligibility . Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Links to various non-Aetna sites are provided for your convenience only. Applicable FARS/DFARS apply. Fee Schedules = "Fee Schedules". The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. 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. Our plans are designed to deliver more personal, aordable and eective health care right in your community. 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 American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. It explains your benefits. Your employer may offer Aetna life insurance plans. 1-800-US- AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM . Members should discuss any matters related to their coverage or condition with their treating provider. 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). 1. full name (first and last name) address/zip code/email/etc. Supplemental materials are supported for SBCs with a coverage effective date of 1/1/2014 or later. Aetna Medical Insurance Policy Number. A car insurance policy number is, on average, is an 8-10 digit number in your car insurance card. To check on the status of your enrollment at Aetna, you can call 1-800 , See Also: aetna medicare member services phone numberShow details, 2 hours ago You can cancel your Aetna life insurance policy online or by phone Aetna customer service can be reached by calling 1-800-872-3862 You will need to write an Aetna termination of coverage , 5 hours ago The Plan ID is a 3-digit number that designates one plan from another for the IRS and DOL. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Your Aetna policy number is located on your identification card. Links to various non-Aetna sites are provided for your convenience only. In Florida and Minnesota, it is approved as a group Medicare Supplement . In the , 4 hours ago First Page. For language services, please call the number on your member ID card and request an operator. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The customer will be required to enter in a PIN when linking out to the following payer space apps: Code Editing Tool = "Code Edit Lookup Tools". It's easy to apply for your NPI. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". If you still cannot locate it there, you can always get in touch with your health insurance plan provider and tell them that you are unable to find the health insur. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Call Other Insurance Companies. You will receive notice when necessary. You are now being directed to the CVS Health site. What is Medicaid in New Jersey called? If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. If you do not intend to leave our site, close this message. Some subtypes have five tiers of coverage. Do you want to continue? Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The SBCs in Mandarin, Tagalog, Spanish, and Navajo are provided upon request. USAA account number followed by the letter "U" and a string of digits. Please note: SBCs with coverage effective dates of 2013 and earlier do not have supplemental materials associated with the SBC. (12 characters with no spaces) Where can I find my policy number? Company Number 0192529 Previous Company Numbers. They do not have access to member Preview / Show more . Need help with Medicare enrollment? For information about: Your insurance or specific plan, contact your companys HR department or your insurance company. Aetna Customer Reviews, 2022 Family-medical.net. 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. This information is neither an offer of coverage nor medical advice. Use the Eligibility and Benefits Inquiry transaction to get details on their 2022 plan. You must receive all routine care from plan providers. 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). The following changes begin on January 1, 2022: When checking your patients eligibility and benefits, use our provider portal on Availity or another vendor or clearinghouse on our list. The use of the GT or 95 modifier is not required for e-visit CPT codes (98970, 98971, 98972), the store-and-forward code (G2010), virtual check-in codes (G2012), and telephone assessment CPT codes (98966, 98967, 98968). Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search." . The company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace. Aetna Provider Phone Number List (California) Aetna Medicare Advantage Plans and. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Visit the secure website, available through www.aetna.com, for more information. Pharmacy. Aetna Student Health partners with over 200 colleges and , 6 hours ago Medicare: Oct. 15Dec. Aetna Dental P.O. When billing, you must use the most appropriate code as of the effective date of the submission. For general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. Is with Aetna, Inc. and no endorsement by the American Medical Association Web site, www.ama-assn.org/go/cpt type! The eligibility and benefits Inquiry transaction to get information at this number FOURTH EDITION ( `` CPT )! 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