aetna member service number

We compensate these health care providers: One of the purposes of managed care is to manage the cost of health care. The mailing address appears on the forms. Aetna Inc. and itsaffiliated 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. 2019 and earlier (non-SilverScript) Prescription Drug Plans (PDPs) Follow these steps: If you received a denial letter based on Milliman Care Guidelines (MCG) criteria that says a link to MCG criteria is available online, you can access the MCG criteria at the link below. Learn about upcoming events in your area and seeour latest news. 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). Contact Member Services at the toll-free number on your ID card for help starting the process. Aetna is part of the CVS Health family of companies. Find care, manage costs, try a health program and more. Reprinted with permission. Medicare Advantage andPrescription Drug Plans, 1-800-307-4830(TTY: 711), And we offer benefits and services for those who qualify. 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). You may call the toll-free number on your member ID card at any time. Froma24-hour nurse line to vision and fitness, youre covered. You can go to the Aetna Better Health website to learn more. If you received a denial letter based on American Society of Addiction Medicine (ASAM) criteria that says a link to the ASAM criteria we used for the review is available online, you can access the ASAM criteria through the form below. Aetna handles premium payments through Payer Express, a trusted payment service. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. A unique program that helps you find services in your community to help manage everyday needs. This search will use the five-tier subtype. CPT only Copyright 2022 American Medical Association. Disclosure of a Financial Interest in the Sale of Health Insurance Policies (PDF). Want to see options for a different location? Others have four tiers, three tiers or two tiers. The ABA Medical Necessity Guidedoes not constitute medical advice. Note to all Illinois consumers affected by the recent significant storms in Christian county: Please read the following policy liberalizations and safeguards Aetna has put in place to help protect your health insurance coverage and give you peace of mind during your recovery process. Others have four tiers, three tiers or two tiers. *FAIR Health Marks and the FAIR Heath Logo are trademarks or registered trademarks of FAIR Health, Inc. Coverage of emergency services and prior authorization requirements for non-emergency surgical or ancillary services performed at in-network facilities. 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. Were you assigned a doctor? Learn about all your plan benefits, from vision and dental care to telehealth, maternity care and help to stop smoking. You must renew your Pennsylvania CHIP coverage each year. 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). Treating providers are solely responsible for medical advice and treatment of members. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to 8 PM ET. Arkansas utilization review statistical reports, Important information: Network provider not reasonably available, Enhanced policy liberalizations for Christian county consumers, Louisiana secondary plans - purpose and use of the benefit reserve, Mental Health Parity and Addiction Equity Act (MHPAEA) summary forms, Massachusetts - Behavioral health child and adolescent services, Massachusetts - Behavioral health and substance use disorder precertification, Massachusetts residents must have health care coverage. Applicable FARS/DFARS apply. This manual will help you understand our health programs and policies for Aetna Dental West Virginia Network Access Plans. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. Monday to Friday, 8 AM to 8 PM ET. Locate network providersandget help choosing the right hearing aids for you and purchase hearing aids. If you are on someone elses insurance and would like us to send your Explanation of Benefits statements and other claim information to an address thats different from the primary subscribers, please call Member Services at the number on your ID card. Or see our non-discrimination notice to learn more. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Washington law requires carriers to post on their website information that identifies each HCBM contracted with them and identify the services provided by HCBMs. Learn more about managing your health care costs. The member's benefit plan determines coverage. In case of a conflict between your plan documents and this information, the plan documents will govern. The AMA is a third party beneficiary to this Agreement. 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 member's benefit plan determines coverage. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Cloudflare Ray ID: 7dff31afbb3ddc9f 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. Aetna members have access to contact information and resources specific to their plans. You are now being directed to the CVS Health site. Well help you understand your coverage. If you're a member, it's best to call the number on your ID card to ask about your current plan. Members should discuss any matters related to their coverage or condition with their treating provider. Online By phone 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. 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. Why choose ${company} Medicare Solutions? Aetna has selected Caremark as the prescription management and mail delivery service for our members. 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. Helpful information on the Savings Plus plan. The claim reimbursement examples (PDF) has examples of average submitted charges and allowances for commonly billed voluntary out-of-network services. All Rights Reserved. Its all about you. You have the right to ask us to communicate with you in a certain way or at a certain location. Physical fitness and wellness programsthat you can getonline or in person. Your InstaMed log-in may be different from your Caremark.com secure member site log-in. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Each health plan has its own contact information. Read and accept the terms and conditions. 1-866-409-0937 ${tty} . Log in to your member website Aetna Medicare contact information Our public online contact form Other ways to reach us Corporate headquarters Price estimates can be made in the Aetna member website. If you dont want to leave the member site, choose the X in the upper right corner to close this message. 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. Employer or Group coverage. Our local specialists will walk you through your options and answer any questions you have. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you dont want to leaveyourstatesite, choose the X in the upper right corner to close this message. The individual who is totally disabled must meet the extension eligibility requirements on the date that coverage would otherwise end. Or choose Go on to move forward to Aetna.com. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. If you do not intend to leave Aetna Medicare, close this message. Arkansas utilization review statistical report - 01/01/2023-03/31/2023 (PDF), Arkansas utilization review statistical report - 10/01/2022-12/31/2022 (PDF), Arkansas utilization review statistical report - 07/01/2022-09/30/2022 (PDF), Arkansas utilization review statistical report - 04/01/2022-06/30/2022 (PDF), Arkansas utilization review statistical report - 01/01/2022-03/31/2022 (PDF), Arkansas utilization review statistical report - 10/01/2021-12/31/2021 (PDF), Arkansas utilization review statistical report - 07/01/2021-09/30/2021 (PDF), Arkansas utilization review statistical report - 04/01/2021-06/30/2021 (PDF), Arkansas utilization review statistical report - 01/01/2021-03/31/2021 (PDF), Arkansas utilization review statistical report - 10/01/2020-12/31/2020 (PDF), Arkansas utilization review statistical report - 07/01/2020-09/30/2020 (PDF), Arkansas utilization review statistical report - 04/01/2020-06/30/2020 (PDF), Arkansas utilization review statistical report - 01/01/2020-03/31/2020 (PDF). Why choose ${company} Medicare Solutions? Or call the number on your ID card. Treating providers are solely responsible for medical advice and treatment of members. CVS Health provides the info on the next page. Contact 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. Contact Us - Health Care Providers | Aetna Links to various non-Aetna sites are provided for your convenience only. Performance & security by Cloudflare. Email, call or chat with us. To access the MCG criteria, enter the following information from your denial letter: 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). Includes PPO, HMO, HMO-POS medical plans with or without drugs. When you choose us as your Pennsylvania Childrens Health Insurance Program (CHIP) health plan, you make the choice for better health. You must request access to the out-of-network provider in advance and we must agree. Connecticut members who received a surprise bill from a nonparticipating provider can get help. You are now being directed to CVS Caremark site. Enter the ASAM Guideline Code from your denial letter in the box below and submit. Mercy Care (Arizona), Aetna Better Health of Illinois (formerly IlliniCare Health). Copyright 2015 by the American Society of Addiction Medicine. Handicapped child/behavioral health attending physician's statement (PDF) For behavioral health conditions in children and adults, and medical conditions in dependents age 18 and younger. They do not have access to member accounts but they can provide Aetna Member Services contact information. All fields marked with an asterisk (*) are required. Or choose Go on to move forward to Aetna.com. Member Services is here to help. Or call us at 1-800-822-2447 (TTY: 711). 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Log in to your account The Appointment of Representative form is on CMS.gov. New and revised codes are added to the CPBs as they are updated. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. iPhone is a registered trademark ofApple Inc. Aetna Better Health Kidscomplies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Just call the number on your invoice or reach out to your Aetna representative. Individual physicians and other providers are in the network by either contracting with us directly or by affiliating with a group or organization that contracts with us. California HMO transition of care coverage policy - English (PDF), California HMO transition of care coverage policy - Spanish (PDF), California traditional transition of care coverage - English (PDF), California traditional transition of care coverage - Spanish (PDF), California hospital and facility enrollee transfer notice (PDF), California new primary care physician and independent physician association enrollee transfer notice - 002 (PDF), California same primary care physician and new independent physician association enrollee transfer notice 012 (PDF), Aetna HMO Colorado Network Access Plan (PDF), Aetna Open Access Managed Care, EPO, PPO Network Access Plan (PDF), Aetna Vision Preferred Network Access Plan (PDF), Aetna Whole Health Network Access Plan (PDF), Colorado surprise bill disclosure - Spanish (PDF), Criteria we use to make coverage decisions. Confidentiality for victims of domestic violence (PDF), 2021 IL Pharmacy Prior Authorization Statistics - Aetna Life Insurance Company and Aetna Health Inc. (PDF), 2021 IL Specialty Precertification Prior Authorization Statistics (PDF), 2021 IL eviCore Prior Authorization Statistics (PDF), 2021 IL Optum Prior Authorization Statistics (PDF), 2021 IL Prior Authorization Statistics - Aetna Life Insurance Company and Aetna Health Inc. (PDF). Or choose Go on to move forward. Youll get inside access to tools and resources to make your job easier, and your patients smiles healthier. Find more information here: Surprise billing member notification (PDF). Note: Doctors, chiropractors and podiatrists must inform you of certain financial interests. See the HCBM Disclosure listing by clicking the below link. . Become an insider. When you get emergency care or youre treated by an out-of-network provider at an in-network hospital, or ambulatory surgical center or by an air ambulance provider, you are protected from surprise billing or balance billing. This manual will help you understand our health programs and policies for Aetna West Virginia PPO Network Access Plan. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. For the purposes of 211 CMR 52.14(1)(c), the term voluntary disenrollment means that an insured has terminated coverage with the carrier for nonpayment of premium. You can change to your current or preferred provider if theyre in our network. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. Already have Availity log-in information? The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. This means that your copayment or coinsurance will never be greater than your in-network copayment or coinsurance. Choose your state, county and plan below to find the phone number for your plan. Si tu intencin no era salir del sitio web, cierra este mensaje. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Dual Eligible Special Needs Plans (D-SNP). Consumer Notice about surprise billing (PDF). Contact Member Services - Member Help | Aetna Medicare 192.95.21.41 If a service or procedure is not listed in the cost estimator in the Aetna member website, a Connecticut member can obtain an estimated cost by completing the appropriate Member Request for Estimate Form. Monday to Friday, 8AM to 8 PMET. Your IP: La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Log in to the member portal or refer to your member documents for additional information. 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. Be sure to check your email for periodic updates. Read more about mandatory coverage in Massachusetts. Aetna Better Health of Virginia HMO SNP. Or log in to your member website and choose "Help" to get phone number, email and chat options. When you choose Aetna Better Health Kids, you make the choice for better health. The ABA Medical Necessity Guidedoes not constitute medical advice. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Aetna has selected Caremark as the prescription management and mail delivery service for our members. Aetna provides info on the next page. It may be different from your Aetna secure member site log in. Contact Us about Medicare Plans | Aetna Medicare Find a seminar Extra benefits From a 24-hour nurse line to vision and fitness, you're covered. If you dont want to leave our site, choose the X in the upper right corner to close this message. Please call your doctor if you have tested positive for COVID-19 and need access to treatment. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. And you can do it all close to home. Access2Care. 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. There is no obligation to enroll. Log in tips First-time users Please register for an account. Or choose Go on to move forward to the provider website. Register for the portal to get access to Aetnas newest tools, resources and customized training opportunities. Were bringing you to our trusted partner to help process your payments. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Just contact Member Services. 7 days a week, 24 hours a day. Your Payer Express log-in may be different from your Aetna secure member site log-in. Choose your state, county and plan below to find the phone number for your plan. If you are enrolled in a plan that uses a comprehensive provider network, you can get covered health services from an out-of-network provider at your in network cost share if an appropriate network provider is not reasonably available. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. W - Clinically undetermined. If you do not intend to leave our site, close this message. It is only a partial, general description of plan or program benefits and does not constitute a contract. Contact Member Services - Member Help | Aetna Medicare Were here for members in select counties. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. The information you will be accessing is provided by another organization or vendor. 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. Aetna Health members, log-in securely to your account to access all of your health and benefits information, or get your user name and/or password if you've forgotten it. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. If you dont want to leave our site, choose the X in the upper right corner to close this message. 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). Monday to Friday, 8 AM to 8 PM ET.

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