This Agreement will terminate upon notice if you violate its terms. Depending on the members MSP eligibility, they may have a cost-share responsibility. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Future changes to CPT or Healthcare Common Procedure Coding System (HCPCS) codes that require PA will be communicated by Aetna Better Health Premier Plan in writing and on the homepage of Aetna Better Healths secure web portal. It is only a partial, general description of plan or program benefits and does not constitute a contract. Provider site; Please america; Search. Copyright 2015 by the American Society of Addiction Medicine. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. Please contact Eviti Connect at. Check your participation status using the provider search tool. Idaho Members: If you contact several providers who have indicated they will see new patients and find you cannot get an appointment, you may call Customer Service at 1-800-936-0978. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Street Address: . Skip to main content . Aetna Better Health of Maryland Medicaid Dental Provider Search. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. symbol is displayed for the code, place your cursor over the symbol to review additional 2020 Avsis Incorporated. Treating providers are solely responsible for medical advice and treatment of members. 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. Others have four tiers, three tiers or two tiers. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. We update our provider directory nightly. 2/22). From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. . The AMA is a third party beneficiary to this Agreement. Pharmacy, dental or vision providers? PA requirements are both Yes and No, as specified on the PA List. All rights reserved | Email: [emailprotected], North country health care university flagstaff. Disclaimer of Warranties and Liabilities. Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. 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. Find a Provider | Aetna Medicaid Illinois 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. New and revised codes are added to the CPBs as they are updated. For language services, please call the number on your member ID card and request an operator. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Pediatric Dentists: provide dental care for children and young adults. Aetna Better Health of Maryland Medicaid Dental Provider Search - Avesis 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. 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. Are you looking for free COVID-19 testing providers? Choose the type of plan you're interested in to search for health care providers that accept it. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. VisitVision Provider Searchto view your vision providers. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. Dental Savings Plans reduce the cost of dental care by 10%-60%, at thousands of participating dentists and dental specialists nationwide. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Enter your location by address, city or zip code. Links to various non-Aetna sites are provided for your convenience only. 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). Aetna Smart Compare is a designation we give to doctors in our network who have proven time and again that they provide high-quality, effective care. New and revised codes are added to the CPBs as they are updated. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Go to the American Medical Association Web site. NON-COV - CPT or HCPCS code entered is not a covered benefit by health plan. CPT is a registered trademark of the American Medical Association. Let Customer Service know the providers you called. Choose from the largest directory of in-person & video visit providers in the nation. 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. Your Plan: Your Plan: 1999- Health Insurance Plans | Aetna Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. All rights reserved. Orthodontists: correct the position of misaligned teeth and jaws, typically this is done with braces although treatments using other dental devices (such as retainers) are also utilized. Please confirm with the provider when you call them. 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. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Find a Provider | Aetna Medicaid Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. Links to various non-Aetna sites are provided for your convenience only. To get started: 1. 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. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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. . Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. The HMO plan is ideal for employers in urban locations who want to offer simple, convenient care with fixed, predictable costs. Prior Authorization may be required. Aetna Provider Search - Small Business Benefits | Trustmark Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Provider Directory. Click here to request an office transfer. 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. 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. CPT only copyright 2015 American Medical Association. Do you want to continue? In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Treating providers are solely responsible for dental advice and treatment of members. Aetna Inc. and itsitsaffiliated 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. 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. Copyright 2015 by the American Society of Addiction Medicine. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. 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. Provider manuals | Manuals | Aetna Better Health of Pennsylvania Our find a dentist tool includes a brief survey to help us improve this service. Or they can help you find a provider. The provider network is subject to change. Please enable it to continue. 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. For language services, please call the number on your member ID card and request an operator. Members must choose a PCP* to guide their treatment and coordinate all specialist care which all takes place in a quality network to keep costs in check. Dental Benefits | Aetna Medicaid West Virginia / Dental Benefits Each plan has its own provider network. INVALID - CPT or HCPCS code entered was invalid, not found. For Use by Doctors and Facilities only. System (HCPCS) codes or a CPT group and select SEARCH. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. HMO Plan*; Open Access Plan; QCHP/CDHP Plan; For step-by-step instructions, click on a plan below. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. (Just Now) WebAetna Better Health dental coverage is a part of Aetna Better Health's overall health insurance plan. It provides coverage for a wide range of dental services, including . Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. In case of a conflict between your plan documents and this information, the plan documents will govern. Oncology treatment plans must be submitted to NantHealth via their web portal, Eviti Connect, which will expedite clinical review of any chemotherapy, radiation therapy, or supportive medications that require prior-authorization. You are now being directed to CVS caremark site. Members should always contact the provider's office in advance to confirm availability. For children and other Medicaid members, dental providers are available through MCNA. Prosthodontists: restore damaged teeth or replace missing ones, with procedures that include dental implants, bridges, crowns and dentures. Please consult with the respective plan detail page for additional plan terms. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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 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). The path to healthy starts here. 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. 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. Unlisted, unspecified and nonspecific codes should be avoided. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. 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). 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. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Select a Plan * Select a Plan: 2. All Rights Reserved. #2020 . Treating providers are solely responsible for medical advice and treatment of members. All Rights Reserved. If you are looking for a specific provider and cannot find them online, need more information,help, or would like a printed copy of the provider directory mailed to you,callus at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. 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". You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . Enter a zip code to search for dental care professionals in your area. The member's benefit plan determines coverage. All Rights Reserved. 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. Find a provider | Aetna Better Health of Louisiana Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. In-network coverage only (except emergency . All DSNP plans are required to have an approved Model of Care. You can all Member Services at 1-866-638-1232, TTY PA Relay 7-1-1 , TTY 711, for help finding a provider.
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