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). If you do not intend to leave our site, close this message. In Pennsylvania, where competition is fierce, there are over 2.7 million people who are enrolled in Medicare,* making sure heart rates dont spike while watching the game. 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. Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Do you want to continue? Includes PPO, HMO, HMO-POS medical plans with or without drugs. I'm glad you contacted us. CPT only Copyright 2022 American Medical Association. After receiving a Medicare scam phone call that asks for your Medicare number or other personal information, reach out to We're here to help. Send us an email and well get back to you as soon as possible. *First Name. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Copyright 2015 by the American Society of Addiction Medicine. 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. This is the phone number for the 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. You've probably heard of them but what does it really mean for you? Others have four tiers, three tiers or two tiers. 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. Dual Eligible Special Needs Plans (D-SNP). Dual Eligible Special Needs Plans (D-SNP). The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Were bringing you to our trusted partner to help process your payments. Having a partner to help you manage a chronic condition. Why choose ${company} Medicare Solutions? 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. CPT only Copyright 2022 American Medical Association. Or simply go to our Get Started page. Visit the secure website, available through www.aetna.com, for more 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. [Virtual care professional] It's my pleasure. 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. 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. Please log in to your secure account to get what you need. CVS Health Virtual Care is all about you. It's easy to update a provider address, phone number, fax number, email address or initiate an out-of-state move or a change in provider group. A Medicare recipient will get a phone call from someone claiming to work for the Center of Medicare and Medicaid Services, the Social Security Administration or an insurance provider. Your benefits plan determines coverage. Members should discuss any matters related to their coverage or condition with their treating provider. Please fill in all fields. WebTelehealth Services for Aetna Members Care anytime, anywhere With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. Members should discuss any matters related to their coverage or condition with their treating provider. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Disclaimer of Warranties and Liabilities. For 2022, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.29 out of 5 stars. No fee schedules, basic unit, relative values or related listings are included in 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. 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. Visit the secure website, available through www.aetna.com, for more information. [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? Treating providers are solely responsible for medical advice and treatment of members. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. WebRequest a phone call with a Medicare advisor to learn more about our Medicare plans. 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). WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. Call us at 1-800-282-5366 ${tty} 7 days a week, 8 AM to 8 PM Your Payer Express log in may be different from your Aetna secure member site log in. Want to see options for a different location? The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. Get a virtual primary care appointment within days, not weeks. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) Health Insurance Marketplace: HealthCare.gov or 1-800-318-2596 2. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. 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. Dual Eligible Special Needs Plans (D-SNP). Plan features and availability may vary by service area. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. All services deemed "never effective" are excluded from coverage. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Then, get a customized treatment plan within two days. If you have questions, reach out to your HR benefits manager. We're here to help. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Applicable FARS/DFARS apply. 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). 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). Care for minor illnesses, mental health and more. The member's benefit plan determines coverage. This Agreement will terminate upon notice if you violate its terms. Treating providers are solely responsible for medical advice and treatment of members. Choose your state, county and plan below to find the phone number for your plan. 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. Some subtypes have five tiers of coverage. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Others have four tiers, three tiers or two tiers. I tell everyone who is having a Want to see options for a different location? No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. This virtual care option is in addition to your traditional network of providers. Do you want to continue? 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. WebUSA. 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