Call Aetna Mail Order Drug at 1-866-612-3862 (TTY: 711). This information is neither an offer of coverage nor medical advice. CPT only Copyright 2022 American Medical Association. Provider termination form and directory update. LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Fax Number: Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. BE SURE TO KEEP COPIES OF CLAIMS SUBMITTED FOR YOUR FILES, MAIL CLAIMS TO: You are now being directed to the CVS Health site. 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. Precertification is recommended, but not required. 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. Members should discuss any matters related to their coverage or condition with their treating provider. We have been serving the construction and building industry since 1961. 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 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). You can visit www.aetnaeducation.com for easy access to training and resources related to MA plans. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Machine Readable Data Provider Network Content for Federally-Facilitated Marketplace (FFM) Qualified Health Request a Drug Coverage decision by Mail: Aetna Medicare Part D Appeals & Grievances, Refer to the back side of the member ID card, Coventry (Including workers compensation and auto injury), Quality Point of Service (Except the ID starts with W), Quality Point of Service (Member ID starts with W), Aetna Provider Phone Number for the following listed plans - 888-772-9682, Aetna Limited Benefits Insurance Plan (PPO), Aetna Voluntary Group Medical Plan (indemnity Plan), 888-702-3862 (Benefit Questions or Claim Inquiries), 888-802-3862 (Benefit Questions or Claim Inquiries), Aetna Vision Discount Programs (California), Aetna Better health Provider Phone Number. 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). 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. Health benefits and health insurance plans contain exclusions and limitations. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. Do not include any dashes, suffixes or spaces. Visit the secure website, available through www.aetna.com, for more information. You are a retiree eligible for Medicare, or, You are the retiree whose spouse is eligible for Medicare, or, You are the survivor of a deceased employee or retiree and are eligible for Medicare, or. License to use 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. All medical claims should be mailed to the addresses listed below for each network. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. WebMail Claims to: Aetna Pharmacy Management. 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 help ensure your clients dont miss this critical step! 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. 79998-1106, Aetna Student HealthSM 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. T1-11 siding is perfect for use on barns and sheds. This Agreement will terminate upon notice if you violate its terms. P.O. A Google Certified Publishing Partner. It is only a partial, general description of plan or program benefits and does not constitute a contract. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. El Paso, TX 79998-1106. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. Learn more about Ezoic here. When billing, you must use the most appropriate code as of the effective date of the submission. 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. WebOn AVA, youll need: Provider billing tax identification number (TIN) or NPI Patient ID or subscribers Social Security number Patient date of birth Date of service range Provider fax number (if a fax back is needed) For inquiries submitted online, please provide: Provider billing tax identification number (TIN) and NPI All Rights Reserved to AMA. LEXINGTON KY 40512-4089 800-354-5835, PO BOX 14100 CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY, Address Paper claims submission Mail to: Aetna PO Box 981106 El Paso, TX 79998-1106. For language services, please call the number on your member ID card and request an operator. Some subtypes have five tiers of coverage. 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. 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. 1. 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 COLUMBIA SC 29224-3759 800-391-5367, PO BOX 981107 Correct rejected claims and resubmit electronically. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. CPT only Copyright 2022 American Medical Association. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Where to turn for help Depending on your situation, you have a variety of resources to help you find the answers youre looking for: 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. PO Box 981106 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. LA, MS, NC, NM, NV, OR, SC, UT, WebYou can talk to Aetna Medicaid Administrators by calling: 602-659-1100 (TTY: 711) Hours: MF, 9 AM5 PM MT By mail You can mail us a letter at: Aetna Medicaid Administrators In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. For language services, please call the number on your member ID card and request an operator. Aetna claims phone number: For Medical coverage decision Mailing Address: Medical Service: PO Box 14079 Lexington, KY 40512-4079 For Medical Appeal Mailing Address: Aetna Medicare Part C Appeal and The ABA Medical Necessity Guidedoes not constitute medical advice. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. 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 non-Aetna sites are provided for your convenience only. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If you do not intend to leave our site, close this message. Aetna HMO 800-624-0756, PO BOX 30545 Your benefits plan determines coverage. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Email: AetSSIinformation@aetna.com. Simplified billing submit one bill to Aetna and receive one remittance. The member's benefit plan determines coverage. Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. Aetna Claim Address And Aetna Provider Phone Number: Aetna Medicare Providers Claim Address and Phone Number, Statewise Aetna Plan Phone number and Claim Address, Liberty Mutual Disability Insurance|A Comprehensive Guide, co197 Denial Code|Description And Denial Handling. 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). 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. Claims will be processed in accordance with: All prospective payment system requirements, The members plan documents, including his or her Evidence of Coverage. 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