No fee schedules, basic unit, relative values or related listings are included in CPT. Were bringing you to our trusted partner to help process your payments. Reprinted with permission. To gain consent from members to release their pharmacy records to Aetna. Treating providers are solely responsible for medical advice and treatment of members. If you have questions about Medicare, call 1-800-MEDICARE (633-4227). 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. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. Links to various non-Aetna sites are provided for your convenience only. 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). Reprinted with permission. Others have four tiers, three tiers or two tiers. Health benefits and health insurance plans contain exclusions and limitations. To apply for Medicare coverage, contact the Social Security Administration at (800) 772 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. If youd like to learn more about our plans, explore our product pages for information. 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. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Why choose ${company} Medicare Solutions? For language services, please call the number on your member ID card and request an operator. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. If you do not intend to leave our site, close this message. 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 SilverScript Prescription Drug Plans (PDPs) Please log in to your secure account to get what you need. [Narrator]Your child has an earache at 2:00 AM? These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. For a complete description of the limitations of Teladoc services, visit Teladoc. Dual Eligible Special Needs Plans (D-SNP). Skip to main content For I practice independently and I want to contract with Aetna. Treating providers are solely responsible for medical advice and treatment of members. 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). 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. 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. All fields marked with an asterisk (*) are required. And you can extend your care to be seen in-person with an in-network provider or schedule an appointment at your local Minute Clinic, just like that. All Rights Reserved. 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). Please fill in all fields. 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. 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. 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. 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. You are now being directed to the CVS Health site. This material is for informational purposes only and is not medical advice. Well need to terminate your existing agreement with us. [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? Report Medicare imposters at 1-800-MEDICARE and ftc.gov/complaint. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. (sneezes) Bless you. Applicable FARS/DFARS apply. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non-Medicare Write to us at Aetna Better Health of Ohio 7400 W. Campus Road New Albany, OH 43054 With our virtual care and telemedicine options, you can talk to a doctor by phone 24/7. Well, for starters, it means you'll have more options for care. Dual Eligible Special Needs Plans (D-SNP). Includes PPO, HMO, HMO-POS medical plans with or without drugs. This site has its own log in. Disclaimer of Warranties and Liabilities. 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. Just like that. 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). 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. And you'll have a partner to help you manage your health every step of the way. Do not give out your Aetna member ID number or other personal information. Do you want to continue? Aetna handles premium payments through InstaMed, a trusted payment service. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. [Narrator] And you'll get support for more than just your physical health. Have questions or need to connect with us? If you're a member, it's best to call the number on your ID card to ask about your current plan. 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. Why choose ${company} Medicare Solutions? Call 1-800-556-1555 (TTY: 711) anytime. To view the form just select Continue. The information you will be accessing is provided by another organization or vendor. Whether you need help managing your chronic condition, or are looking to schedule a wellness visit, CVS Health Virtual Primary Care makes it simple. Aetna handles premium payments through Payer Express, a trusted payment service. 3. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. Staff on the nurse call line cannot WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. We'll try our best to get back to you within 24 hours. Visit the secure website, available through www.aetna.com, for more information. Why choose ${company} Medicare Solutions? Access your health information, lab results and personalized tips from anywhere with your health dashboard. WebUSA. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. You are leaving our Medicare website and going to our non-Medicare website. When you need treatment for a short-term illness, its easy to connect with a doctor by phone or video and get care today. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. This site has its own log in. The member's benefit plan determines coverage. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. As we develop more health problems, our risk score increases. 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). Want to see options for a different location? CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Access your health every step of the way plan defines which services are covered, which are to. Were bringing you to our trusted partner to help process your payments our trusted to. 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