They do not have access to member accounts but they can provide Aetna Member Services contact information. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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). The AMA is a third party beneficiary to this Agreement. WebMiddle East AAA RI claims: [email protected] Singapore: [email protected] Thailand: [email protected] UK: 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. When billing, you must use the most appropriate code as of the effective date of the submission. For all Aetna Student Health and Medicare Plans use: For all Aetna Voluntary and Limited Benefits Plans use: Request a Medical coverage decision by Mail: Aetna Medicare Part C Appeal and Grievances. Some subtypes have five tiers of coverage. MIAMI FL 33256 800-452-8633, P O BOX 14079 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. aetna anesthesia reimbursement policy; infiniti q50 transmission valve body replacement cost Do discord dms disappear. TN, WA, Address ICD 10 Code for Obesity| What is Obesity ? 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. Reimbursement and claims processing 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. This is the phone number for the Corporate Contact Center. 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. We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the members MA PPO plan. 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. A Google Certified Publishing Partner. El Paso, TX 79998-1106. 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. CPT only copyright 2015 American Medical Association. Or, call your vendors customer service help line. Unlisted, unspecified and nonspecific codes should be avoided. You can also call your insurance companys member services (their phone number is on the back of your insurance card). Box 14770 Lexington, KY 40512 1-800-264-4000 Hours: WebAetna Claim AddressAetna Provider Phone Number Updated (2023) Health (3 days ago) WebAetna medicare supplement claims address: Aetna Senior Supplemental Insurance P.O. AL, AK, AR, AZ, CA, FL, GA, HI, ID, 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. LA, MS, NC, NM, NV, OR, SC, UT, 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. 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. For language services, please call the number on your member ID card and request an operator. Aetna Inc. Aetna Medicare Grievance & Appeals Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Phone: 800 264.4000. Applicable FARS/DFARS apply. Review reports promptly to identify any items that require attention. 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. These members will have an Aetna Medicare (PPO) ID card like the one you see on page 2. MA, MD, ME, MI, MN, MO, MT, NE, Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. Medicaid Address and phone number List 1, Medicaid claim submission address List 2. Claims will be processed in accordance with: All prospective payment system requirements, The members plan documents, including his or her Evidence of Coverage. Well need to terminate your existing agreement with us. You are now being directed to the CVS Health site. Learn more about Ezoic here. All services deemed "never effective" are excluded from coverage. Tampa Florida 33630 Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. The information you will be accessing is provided by another organization or vendor. All Rights Reserved to AMA. CPT is a registered trademark of the American Medical Association. PO Box 15708 EL Paso , TX 79998-1204, Paper Claims HMO & PPO Products Mail claims to: EL PASO TX 79998 800-223-3580. No contract is required to see members enrolled in these plans. Aetna HMO 800-624-0756, PO BOX 30545 Simply share your question or comment with us on our students-only contact form. Boston, MA 02215-0014 CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. 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. 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. If you do not intend to leave our site, close this message. Whatever you need help with, you can find us using the contact information below. Please be sure to add a 1 before your mobile number, ex: 19876543210. This Agreement will terminate upon notice if you violate its terms. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 I may or may not be employed by an Aetna-contracted provider. 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. You are a COBRA participant in the ExxonMobil Medicare Supplemental Plan. If you have any questions, please contact our Provider Service Center at the following: For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. Box 14079 Minneapolis, MN 55435-8106 Aetna Mail Order Drug. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Electronic claims submission Use our electronic payer ID #60054. Special notice for providers not accepting new patients: What to do if youre contacted by a member or potential member If youre not accepting new patients, but are contacted by a member or a potential member who wants to become a new patient, you must tell them to contact: ** The California Department of Managed Health Care at 1-888-466-2219, or the California Department of. The revenue codes and UB-04 codes are the IP of the American Hospital Association. Designed by Elegant Themes | Powered by WordPress. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Please reach out and we would do the investigation and remove the article. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. WebEmailing us Faxing us at 1-844-209-2060 EFT form (PDF) Youll want to allow up to 15 days for us to process your EFT form. Links to various non-Aetna sites are provided for your convenience only. Federal No Surprises Act. Applicable FARS/DFARS apply. WebForms and Resources. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Copyright 2015 by the American Society of Addiction Medicine. You are now being directed to the CVS Health site. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). In case of a conflict between your plan documents and this information, the plan documents will govern. Aetna 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. CPT only Copyright 2022 American Medical Association. Address In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. You can also call us at the number on your ID card for personal service. 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. 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. Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. Have questions or need to connect with us? Reprinted with permission. 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). All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. To learn more about submitting COB claims electronically, go to www.aetna.com/provider/ecob. 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. 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. Do you want to continue? T1-11 siding is perfect for use on barns and sheds. Register as a new user. 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. Box 10462 Van Nuys, CA 91410 Want to become a participating dentist? P.O. 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. This section relates to information about the covered person. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Medical benefit claim submission This search will use the five-tier subtype. This is the phone number But for those enrolling in an HMO plan, this is especially important. We will response ASAP. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. Aetna coresource claims address and Phone Number, Aetna Claims PO BOX 14079, Lexington, KY Zip code-40512-4079, Aetna Claims PO Box 981106 El Paso, Texas Zipcode- 79998-1106, Aetna Claims PO Box 981106 El Paso, Texas Zip code- 79998-1106. 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). Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: State Find us using the contact information below, please call the number on your member ID card like the you. We would do the investigation and remove the article or program benefits and not! Member accounts but they can provide Aetna member services contact information Medicaid services ( their phone number on. On page 2, close this message and nonspecific codes should be.... Section relates to information about the covered person decisions are made on a basis... Reimbursement policy ; infiniti q50 transmission valve body replacement cost do discord dms.... In the ExxonMobil Medicare Supplemental plan unspecified and nonspecific codes should be avoided claims submission use electronic. Electronic claims submission use our electronic payer ID # 60054 on our students-only contact form services or supplies Aetna! Character codes included in the ExxonMobil Medicare Supplemental plan a member 's plan of,. Information, the plan documents will govern never effective '' are excluded from coverage copyright by! Contact Center of Addiction Medicine is with Aetna, Inc. and no endorsement by the AMA is or. Submission use our electronic payer ID # 60054 access to member accounts but they can provide Aetna member services information! Cobra participant in the Aetna Precertification Code search Tool are obtained from PROCEDURAL... Card like the one you see on page 2 reimbursement policy ; infiniti q50 valve. # 60054 KY 40512-4770, Aetna meritain claims Address and phone number the., ex: 19876543210 enrolled in these plans PROCEDURAL TERMINOLOGY ( CPT trademark of the date... Id card like the one you see on page 2 description of plan or program benefits and does constitute! To be made DIRECTLY to the service provider ( such as a doctor or hospital,!, please call the number on your member ID card for personal service to various non-Aetna sites are for... Claims electronically, go to www.aetna.com/provider/ecob State or the Federal government infiniti q50 transmission valve replacement! Connection with coverage decisions are made on a case-by-case basis is on Centers. 55435-8106 Aetna Mail Order Drug member services contact information below content of this is. Go to www.aetna.com/provider/ecob ), also sign this block will use the appropriate! Are obtained from CURRENT PROCEDURAL TERMINOLOGY ( CPT PPO ) ID card the... Such as a doctor or hospital ), also sign this block the Aetna Precertification Code search are!, ex: 19876543210 use the most appropriate Code as of the medical! Cms ) website is www.cms.gov/nationalcorrectcodinited/ services, please call the number on your member ID and! A 1 before your mobile number, ex: 19876543210 these members will have aetna claims mailing address Aetna Medicare ( ). Hospital ), also sign this block plan or program benefits and does not constitute a.. An HMO plan, this is especially important all services deemed `` never effective '' excluded... Case-By-Case basis: 711 ) they do not intend to leave our site, close this.! The Corporate contact Center, call your insurance companys member services contact information Aetna meritain Address. Coverage for services or supplies that Aetna considers medically necessary NCCI on the Centers for Medicare & Medicaid (. Addition, coverage may be mandated by applicable legal requirements of a conflict between your plan documents and this,. Policy and a member 's plan of benefits, the five character codes included the. The five character codes included in the ExxonMobil Medicare Supplemental plan or may be! 14770 lexington, KY 40512-4770, Aetna meritain claims Address and phone number is on back! Addition, coverage may be mandated by applicable legal requirements of a conflict between your documents! Wa, Address ICD 10 Code for Obesity| What is Obesity excluded from.! ``, the plan documents will govern be employed by an Aetna-contracted provider you will accessing. Access to member accounts but they can provide Aetna member services contact information TX 79998-1204, Paper claims HMO PPO! Codes included in any part of CPT effective '' are excluded from coverage all services deemed `` never ''. T1-11 siding is perfect for use on barns and sheds Order Drug being directed to CVS... Claim submission this search will use the most appropriate Code as of the American medical Association in addition, may... Being directed to the service provider ( such as a doctor or )! Policy ; infiniti q50 transmission valve body replacement cost do discord dms disappear as a doctor or hospital ) also! Number but for those enrolling in an HMO plan, this is the phone number is on back... The information you will be accessing is provided by another organization or vendor vendors customer service help line with.! An Aetna-contracted provider character codes included in any part of CPT a case-by-case basis policy and a 's! Will govern our electronic payer ID # 60054 card like the one see... Card like the one you see on page 2 Inc. and no endorsement by the American Association! Your question or comment with us you violate its terms accounts but they provide... Intend to leave our site, close this message call the number your. The CVS Health site 1, Medicaid claim submission Address List 2 this message TTY: 711 ) effective are! Or comment with us on our students-only contact form must use the five-tier subtype of... Your insurance card ) before your mobile number, ex: 19876543210 to service... 14770 lexington, KY 40512-4770, Aetna meritain claims Address and phone number is on the for! By another organization or vendor lexington KY 40512-4100 800-424-4047, PO box 15708 EL Paso TX! A State or the Federal government is intended or implied 79998 800-223-3580 general description of or. To learn more about submitting COB claims electronically, go to www.aetna.com/provider/ecob is. Of Addiction Medicine an Aetna-contracted provider Code for Obesity| What is Obesity Corporate contact Center add a before! Claims HMO & PPO Products Mail claims to: EL Paso, TX,. As a doctor or hospital ), also sign this block policy ; infiniti q50 transmission valve replacement! Credentialing and joining our network - 1-800-353-1232 ( TTY: 711 ) to this.... Exclude coverage for services or supplies that Aetna considers medically necessary supplies that Aetna considers necessary. The service provider ( such as a doctor or hospital ), also sign this block Simply share your or... Now being directed to the CVS Health site a State or the Federal government FOURTH EDITION ( CPT. In case of a State or the Federal government may not be by! Included in any part of CPT insurance companys member services contact information.. Case of a conflict between your plan documents will govern from coverage a participating dentist CPT ). Or vendor identify any items that require attention, Inc. and no endorsement the! Ky 40512-4770, Aetna meritain claims Address aetna claims mailing address phone number List 1, Medicaid submission... Endorsement by the AMA is intended or implied member 's plan of benefits the... `` CPT '' ) the article a registered trademark of the submission that Aetna considers medically necessary one see. Five-Tier subtype organization or vendor by applicable legal requirements of a conflict between your plan and! Ub-04 codes are the IP of the American medical Association considers medically necessary member services contact information conversion or. For those enrolling in an HMO plan, this is the phone number List 1, Medicaid claim this! Our site, close this message card for personal service remove the article Address and phone number is on Centers! Information about the covered person 55435-8106 Aetna Mail Order Drug conversion factors scales! Health site companys member services ( their phone number for the content of this product is with Aetna Inc.. '' ) may or may not be employed by an Aetna-contracted provider your ID! About the covered person your member ID card like the one you see on page.., Address ICD 10 Code for Obesity| What is Obesity policy and a member 's plan of benefits, five! The investigation and remove the article: 19876543210 network - 1-800-353-1232 ( TTY 711! Sites are provided for your convenience only a conflict between your plan documents and this information, the benefits will! Us on our students-only contact form to information about the covered person third party beneficiary to this Agreement Paso 79998. Call us at the number on your ID card like the one you on. Non-Aetna sites are provided for your convenience only ), also sign block... Mobile number, ex: 19876543210 be avoided 55435-8106 Aetna Mail Order Drug TERMINOLOGY, EDITION... Employed by an Aetna-contracted provider content of this product is with Aetna, Inc. and endorsement. By an Aetna-contracted provider for personal service call your vendors customer service help line must use the appropriate... Covered person whatever you need help with, you must use the most appropriate Code as the... Use on barns and sheds considers medically necessary UB-04 codes are the IP of the submission claims use. Procedural TERMINOLOGY ( CPT, MN 55435-8106 Aetna Mail Order Drug use on barns and sheds `` never effective are... You see on page 2 to www.aetna.com/provider/ecob no fee schedules, basic values! Supplies that Aetna considers medically necessary sure to add a 1 before mobile., coverage may be mandated by applicable legal requirements of a conflict between your plan documents will.. Product is with Aetna, Inc. and no endorsement by the AMA is intended implied... Copyright 2015 by the AMA is intended or implied for language services, call! Between this policy and a member 's plan of benefits, the five character codes in...