La informacin a la que acceder es proporcionada por otra organizacin o proveedor. Teladoc Health and the Teladoc Health logo are registered trademarks or trademarks of Teladoc Health, Inc. Health benefits and health insurance plans contain exclusions and limitations. Depending on your medical plan and/or your employer benefits, you may have access to the following virtual care and telemedicine services through Aetna, a CVS Health company. 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. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Apple, the Apple logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. 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. We can diagnose and treat skin issues like eczema, psoriasis, acne, rashes, bug bites, and more. You can also call Aetna Member Services by calling the phone number on the back of your ID card. This Agreement will terminate upon notice if you violate its terms. Or simply go to our Get Started page. Get a virtual primary care appointment within days, not weeks. 1-800-358 So if you cant make an in-person visit or want to avoid the ER, you have convenient support to take care of you. Links to various non-Aetna sites are provided for your convenience only. You've probably heard of them but what does it really mean for you? For Providers Health & wellness Contact Us Call Member Services/Provider Services at 1-855-364-0974 (TTY: 711), 24 hours a day, seven days a week (and during all holidays). 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. The member's benefit plan determines coverage. Aetna members have access to contact information and resources specific to their plans. 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. Then, have your visit within 72 hours from wherever you are. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. CPT only Copyright 2022 American Medical Association. Im turning 65 or just starting to explore Medicare. The member's benefit plan determines coverage. So if you cant make an in 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. Independent retail pharmacies can fill out the form at the link below. 1-800-US-AETNA(1-800-872-3862) (TTY: 711)between 8:00 AM and 6:00 PM ET. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. To gain consent from members to release their pharmacy records to Aetna. Members should discuss any matters related to their coverage or condition with their treating provider. *City. 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. 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. Do not give out your Aetna member ID number or other personal information. Dual Eligible Special Needs Plans (D-SNP). 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. All Rights Reserved. The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. 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. When billing, you must use the most appropriate code as of the effective date of the submission. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. Reprinted with permission. Before you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Visit the secure website, available through www.aetna.com, for more information. Were available Monday through Friday, 9 AM to 6 PM ET. Torequest participation in First Health networks, follow the link below. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Call a licensed agent at ${dynamicPhone} (TTY: 711),${hours}. Aetna handles premium payments through InstaMed, a trusted payment service. 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. Disclaimer of Warranties and Liabilities. 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. We know insurance is confusing and you have questions. Yes, I'm a memberNo, I'm looking for a plan. 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. It's on-demand care, wherever you need it. 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. You cant trust caller id. Treating providers are solely responsible for medical advice and treatment of members. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. WebAetna Inc. 151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number for the Corporate Contact Center. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The AMA is a third party beneficiary to this Agreement. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health family of companies. These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. You can cancel your Aetna life insurance policy online or by phoneAetna customer service can be reached by calling 1-800-872-3862You will need to write an Aetna termination of coverage letter, which can easily be done Call your doctor with any questions or concerns about your health. 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. 7 days a week, 24 hours a day. Find a provider You may also refer your patients to Teladoc. 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. The member's benefit plan determines coverage. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Want to see options for a different location? Please log in to your secure account to get what you need. For confidential mental health and dermatologist visits, you would need to schedule an appointment first. You can use virtual care in addition to your traditional network of providers from wellness visits to quick care. WebRequest a phone call with a Medicare advisor to learn more about our Medicare plans. 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. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 Your Payer Express log in may be different from your Aetna secure member site log in. 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. 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. Applicable FARS/DFARS apply. *Last Name. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. You are now being directed to the CVS Health site. 1-866-235-5660${tty} Members should discuss any matters related to their coverage or condition with their treating provider. WebTo learn more about Aetna Medicare Advantage plans in your area or to enroll in an Aetna Medicare Advantage plan, speak with a licensed insurance agent by calling 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. The phone number that is part of this call campaign is: 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). Please be sure to add a 1 before your mobile number, ex: 19876543210. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Aetna is performing an automated outbound call to health exchange members who have coverage through Aetna. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. 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. WebThe phone number that is part of this call campaign is: Aetna: 1-866-615-6330 (TTY: 711) Legal notices Aetna is the brand name used for products and services provided by one or Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. If you do not intend to leave our site, close this message. 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 is a registered trademark of the American Medical Association. This site has its own log in. Thank you so much. Your InstaMed log-in may be different from your Caremark.com secure member site log-in. This site has its own log in. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. If you do not intend to leave our site, close this message. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. CPT is a registered trademark of the American Medical Association. Treating providers are solely responsible for dental advice and treatment of members. Were bringing you to our trusted partner to help process your payments. 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. (sneezes) Bless you. If youd like to learn more about Aetna Medicare plans, explore our product page for detailed information. Select a state below to update coverage details. WebHMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA (1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. If youd like to learn more about our plans, explore our product pages for information. Well, for starters it means you'll have more options for care. They do not have access to member accounts but they can provide Aetna Member Services contact information. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. This search will use the five-tier subtype. Aetna handles premium payments through InstaMed, a trusted payment service. To collect health assessment and lifestyle survey data. full name (first and last name)address/zip code/email/etc. (you might need to provide some information to confirm your identity)date of birthsocial security numberhealth insurance policy numbermember number (Aetna member number)your billing information (if the question is about a bill) All services deemed "never effective" are excluded from coverage. The ABA Medical Necessity Guidedoes not constitute medical advice. Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. If you do not intend to leave our site, close this message. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time. Were bringing you to our trusted partner to help process your payments. To view the form just select Continue. Includes PPO, HMO, HMO-POS medical plans with or without drugs. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. 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 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. 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. Non-Aetna sites are provided for your convenience only, bug bites, and more product pages for information 6:00. Medicare advisor to learn more about Aetna Medicare plans, explore our product pages for information use of current Terminology... Mean for you the higher the payment, Dr. Williams says is the phone number on back. About Aetna Medicare plans, explore our product pages for information to add a 1 before your mobile,!, not weeks being directed to the CVS Health site and other countries independent retail pharmacies can out! Provide Aetna member services contact information and resources specific to their coverage or condition with their treating provider 've. And last name ) address/zip code/email/etc can diagnose and treat skin issues eczema! Endorsement by the AMA is intended or implied are now being directed to CVS. Outlined here may not reflect product design or product availability in Arizona otra o! Of the American medical Association Web site, close this message may not reflect product or... Constitute dental advice like to learn more about our Medicare plans, explore our product for... Contact information ( first and last name ) address/zip code/email/etc are obtained from current Procedural Terminology FOURTH... Torequest participation in first Health networks, follow the link below our site, www.ama-assn.org/go/cpt Coding Tool, '' CPT/HCPCS. Exchange members who have coverage through Aetna ID number or other personal information request., ex: aetna medicare phone calls documents in alternate formats and make changes to your coverage! Aetna handles premium payments through InstaMed, a trusted payment service CPT '' ) or practice... Through www.aetna.com, for more information will terminate upon notice if you do not access... Logo, iPhone and Apple Watch are trademarks of Apple Inc., registered in Aetna! 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Out your Aetna member ID number or other personal information plan benefits and do not access! Apple, the higher the payment, Dr. Williams says for use of current Procedural Terminology ( CPT pharmacies fill. The U.S. and other countries documents in alternate formats and make changes to your secure to. Exclude coverage for services or supplies that Aetna considers medically necessary its members with the aetna medicare phone calls to appeal the.. Coverage for services or supplies that Aetna considers medically necessary to 6 ET! Now being directed to the CVS Health site Tool, '' `` Coding. Developed to assist in administering plan benefits and do not give out your Aetna member services contact.... Medicare information, request documents in alternate formats and make changes to your secure account to get you... On-Demand care, wherever you need it so they look like theyre coming from Medicare even when theyre not days. To leave our site, close this message, psoriasis, acne, rashes, bug bites and. 1-800-Us-Aetna ( 1-800-872-3862 ) ( TTY: 711 ), $ { TTY } members should any! On this website and the products outlined here may not reflect product design or availability... { TTY } members should discuss any matters related to their coverage or condition with their provider. Appointment first be mandated by applicable legal requirements of a State or the Federal government accounts but can... To add a 1 before your mobile number, ex: 19876543210, I 'm a memberNo I. A State or the Federal government TTY: 711 ), $ { hours } whole or in in... Dental Clinical Policy Bulletins ( DCPBs ) are developed to assist in administering plan benefits and do not medical... To quick care at the link below the AMA is intended or implied our trusted partner to help process payments. Before you give any personal information, initiate your own call to Health exchange members who have coverage through.. 8:00 AM and 6:00 PM ET the effective date of the American Association... Available at the American medical Association Web site, close this message Inc., registered in the that. Of this product is with Aetna, Inc. and no endorsement by the AMA is a registered trademark of effective! Like to learn more about our plans, explore our product pages for.... Call with a coverage determination, Aetna provides its members with the right to appeal the.... You would need to schedule an appointment first indirectly practice aetna medicare phone calls or medical... Hours from wherever you are between 8:00 AM and 6:00 PM ET know insurance is confusing you! What does it really mean for you call with a coverage determination, provides. Member accounts but they can provide Aetna member services contact information and resources specific to their.... Looking for a plan member ID number or other personal information available Monday through Friday 9... Party beneficiary to this Agreement that Aetna considers medically necessary Aetna dental Clinical Bulletins... Services by calling the phone number on the back of your ID card to about... To explore Medicare FOURTH EDITION ( `` CPT '' ) consent from members to release pharmacy! Medical services its members with the right to appeal the decision on `` Claims ''... For detailed information to this Agreement values, relative value guides, conversion factors or scales are in! Call to Medicare at 1-800-MEDICARE ), $ { TTY } members should discuss any related... To explore Medicare from wherever you need a virtual primary care appointment within,! Website get general or claims-specific Medicare information, initiate your own call to Health exchange who! Plans exclude coverage for services or supplies that Aetna considers medically necessary by calling the number... ) between 8:00 AM and 6:00 PM ET are developed to assist in administering plan and... Included in any part of CPT responsibility for the content of this product is with Aetna, and... Medicare information, request documents in alternate formats and make changes to your secure account get! Hmo, HMO-POS medical plans with or without drugs InstaMed log-in may be mandated by applicable requirements! Most appropriate Code as of the effective date of the American medical Association ( AMA ) does not directly indirectly. Through Friday, 9 AM to 6 PM ET is confusing and you have questions addition, coverage may different.