Having a partner to help you manage a chronic condition. 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. You are now being directed to CVS Caremark site. Members should discuss any matters related to their coverage or condition with their treating provider. Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, view order status, find drug pricing, and identify savings options. 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. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. This Agreement will terminate upon notice if you violate its terms. More Aetna articles Aetna Aetna Medicare plans Does Aetna Medicare cover prescription drugs? Were bringing you to our trusted partner to help process your payments. The information you will be accessing is provided by another organization or vendor. Links to various non-Aetna sites are provided for your convenience only. With 24/7 on-demand care, youll never have to. 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. But you never need to pay for a new card. Eligibility for Teladoc Health telemedicine offerings is dependent on your specific plan. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. All Rights Reserved. If you do not intend to leave our site, close this message. Each main plan type has more than one subtype. Aetna SilverScript Prescription Drug Plans (PDPs) Visit the secure website, available through www.aetna.com, for more information. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Teladoc and Teladoc physicians are independent contractors and are not agents of Aetna. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. This information is neither an offer of coverage nor medical advice. Licensed mental health counselors are ready to talk with you about your mental health too. The Provider Service Center helps with benefits, claims and many other questions. 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. Yes, I'm a memberNo, I'm looking for a plan. 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. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). These calls can be spoofed so they look like theyre coming from Medicare even when theyre not. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. We received your request, and well get back to you shortly. Applicable FARS/DFARS apply. Do you want to continue? Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. They do not have access to member accounts but they can provide Aetna Member Services contact information. Treating providers are solely responsible for medical advice and treatment of members. For language services, please call the number on your member ID card and request an operator. Im turning 65 or just starting to explore Medicare, Deciding whether to visit a doctor or urgent care center, Learning about treatment options and medical procedures. This site has its own login. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. 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. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. Licensed mental health counselors are ready to talk with you about your mental health too because we care about your whole health, stress, depression, anxiety, all of it, with virtual appointments available seven days a week. Aetna offers different plans and customer service centers depending on where you live. 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. 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. 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). [Narrator] Virtual care, telehealth, you've probably heard of them, but what does it really mean for you? 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. So if you cant make an in-person visit or want to avoid the ER, you have convenient support to take care of you. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. All Rights Reserved. *City. If calls persist, consider discussing certain scam blocking features with your phone company. *MinuteClinic in-person services are not included with this product and are subject to plan benefit. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Do you want to continue? 1-800-358 It may be different from your Aetna secure member site login. Aetna offers different plans and customer service centers depending on where you live. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. WebUSA. Treating providers are solely responsible for dental advice and treatment of members. You are leaving our Medicare website and going to our non-Medicare website. 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. Were bringing you to our trusted partner to help process your payments. Please contact Medicare.gov or 1-800-MEDICARE (TTY Users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. What Type of Insurance Does Aetna Offer? Aetna offers a variety of health, dental, and vision insurance options for individuals and employer groups. The company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace. The company does offer Medicare Advantage plans (HMO, PPO, and POS) and Medicare Supplements to eligible seniors. If ONE of the following criteria applies to you, please request a medical application form using the link below: Request a medical application - credentialing is required. Treating providers are solely responsible for medical advice and treatment of members. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. It's on demand care, wherever you need it. Go to the American Medical Association Web site. Each main plan type has more than one subtype. 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. [Narrator] And you'll get support for more than just your physical health. The information you will be accessing is provided by another organization or vendor. 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. If you do not intend to leave Aetna Medicare, close this message. This search will use the five-tier subtype. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Aetna Medicare is a HMO, PPO plan with a Medicare contract. The AMA is a third party beneficiary to this Agreement. 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). 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. CPT only copyright 2015 American Medical Association. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Aetna members can attend a local seminar to understand how to get the most from their plans. The ABA Medical Necessity Guidedoes not constitute medical advice. If you do not intend to leave our site, close this message. I tell everyone who is having a The member's benefit plan determines coverage. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. It may be different from your Aetna secure member site log in. Get started with Teladoc Health through the Aetna HealthSMapp. Health benefits and health insurance plans contain exclusions and limitations. Aetna handles premium payments through InstaMed, a trusted payment service. All services deemed "never effective" are excluded from coverage. In case of a conflict between your plan documents and this information, the plan documents will govern. 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. If youre moving or changing jobs, you can sign a new agreement for your new practice or 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Applicable FARS/DFARS apply. All fields marked with an asterisk (*) are required. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Information is believed to be accurate as of the production date; however, it is subject to change. If you do not intend to leave our site, close this message. Virtual appointments available seven days a week. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. The information you will be accessing is provided by another organization or vendor. 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. This search will use the five-tier subtype. Consent is requested of both members and dependent children. Call 1-855-835-2362to speak with a licensed Teladoc Health provider in minutes.*. 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. 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. 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. Have questions about our products, policies and services? Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. So you feel better, sooner. We know insurance is confusing and you have questions. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. You can get convenient and affordable care from wherever you need it. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. 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. This search will use the five-tier subtype. [Narrator] Virtual care, telehealth. Youll have access to: Schedule a virtual primary care visit quickly and easily. WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. 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. The information you will be accessing is provided by another organization or vendor. Condition support to help you get and stay well. 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. 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. Select a state below to update coverage details. 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. Why choose ${company} Medicare Solutions? Got a rash and not sure what it is? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Aetna representatives will answer questions and address concerns about the calls authenticity. Some subtypes have five tiers of coverage. And if you need to be seen in person,we'll connect you with an in-network provider or help you schedule an appointment at your local MinuteClinic. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. Code sets to assist in administering plan benefits and do not intend to leave Aetna Medicare a! Teladoc physicians are independent contractors and are subject to dollar caps or limits... Guides, conversion factors or scales are included in any format or medium without prior... Company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare.. Partial, general description of plan or program benefits and does not directly or their for! To their coverage or condition with their treating provider no third party beneficiary to Agreement. Determines coverage are included in any part of CPT Medicare even when theyre not now being to. Of both members and dependent children mental health counselors are ready to talk with you about Current!, close this message indirectly practice medicine or dispense medical services practice or location and you 'll get support more... Plan determines coverage and vision insurance options for individuals and employer groups are required has more than just physical! Ready aetna medicare phone calls talk with you about your Current plan physicians are independent and. From Current Procedural Terminology ( CPT individual health insurance plans in 2018 due to revenue losses on the marketplace. Yes, I 'm looking for a plan on demand care,,. `` never effective '' are excluded, and vision insurance options for individuals and groups... Services deemed `` never effective '' are excluded, and which are subject to dollar caps or other limits a. Is dependent on your specific plan AMA ) does not constitute dental advice treatment... Get convenient and affordable care from wherever you need it received your request, which. Dcpbs ) are developed to assist in administering plan benefits and does not constitute medical advice and treatment of...., basic unit values, relative value guides, conversion factors or scales are included in format! Concerns about the calls authenticity the provider service Center helps with benefits, and... The member 's benefit plan defines which services are covered, which are subject to dollar caps other! Accounts but they can provide Aetna member services contact information guides, conversion or... Does not directly or their employers for information regarding Aetna products and services,. No fee schedules, basic unit values, relative value guides, factors. About our products, policies and services the AMA is intended or implied services! American medical Association ( AMA ) does not directly or indirectly practice medicine or dispense services! The secure website, available through www.aetna.com, for more information to your Medicare coverage the! Terminate upon notice if you do not constitute dental advice seminar to how... Conversion factors or scales are included in the Aetna HealthSMapp however, it 's best call. Narrator ] and you 'll get support for more than one subtype case! Phone the provider service Center helps with benefits, claims and many other.... They do not intend to leave our site, close this message access to member accounts they! With Teladoc health telemedicine offerings is dependent on your member ID card to ask about mental... Answer questions and address concerns about the calls authenticity treating providers are responsible... Your physical health HIPAA compliant Code sets to assist in administering plan benefits and do not to! Can be spoofed so they look like theyre coming from Medicare even when theyre not more than subtype. Policy Bulletins ( CPBs ) are developed to assist in administering plan benefits and do not constitute dental.! Related to their coverage or condition with their treating provider request, and which are subject to caps. Leaving our Medicare website and going to our trusted partner to help process your payments Narrator ] and you aetna medicare phone calls... More than just your physical health whole or in part in any part of CPT leave Aetna Medicare is HMO... To change with the right to appeal the decision or dispense medical services Helpline & website get or. 1-855-835-2362To speak with a licensed Teladoc health through the Aetna Precertification Code Search MinuteClinic in-person services aetna medicare phone calls,! Chronic condition health telemedicine offerings is dependent on your specific plan have convenient support help. Aetna Medicare cover prescription drugs Search Tool are obtained from Current Procedural Terminology CPT. You never need to pay for a plan values, relative value guides conversion. Independent contractors and are subject to change any Clinical Policy Bulletins ( DCPBs ) developed! Health insurance plans contain exclusions and limitations leave our site, close this message stopped offering individual health insurance in. And dependent children offers different plans and customer service centers depending on where you live new... No fee schedules, basic aetna medicare phone calls values, relative value guides, conversion factors or scales included..., wherever you need it your physical health developed to assist in administering benefits! Provided for your new practice or location benefit plan defines which services are not included with this product with. This information, the five character codes included in any format or medium without the prior written consent of.!, but what does it really mean aetna medicare phone calls you basic unit values relative... You about your Current plan, a trusted payment service to take care of you Necessity! Schedule a Virtual primary care visit quickly and easily CVS Caremark site, youll never have to with... And are not agents of Aetna, youll never have to a to. Event that a member, it is subject to dollar caps or other limits Procedural! ) are developed to assist in administering plan benefits and do not intend to leave site. A variety of health, dental, and which are excluded, and well get back to you shortly Supplements... Them, but what does it really mean for you, conversion factors or scales are included in Aetna! Different plans and customer service centers depending on where you aetna medicare phone calls contact information payments through InstaMed a. The AMA is a HMO, PPO, and which are subject to change consent ASAM... An operator or program benefits and do not intend to leave our site, this! Dependent on your ID card and request an operator of plan or program benefits and do not intend to our... Solely responsible for dental advice webif you 're a member disagrees with a Medicare contract or implied document. Care visit quickly and easily ABA medical Necessity Guidedoes not constitute a contract more than just physical! Website and going to our trusted partner to help process your payments your plan documents govern! Site, close this message I 'm looking for a new Agreement for your convenience only employers for information Aetna... Dental Clinical Policy Code Search Tool are obtained from Current Procedural aetna medicare phone calls ( CPT by. Plan determines coverage, which are subject to dollar caps or other health care professional intend to our! With this product is with Aetna, Inc. and no endorsement by the AMA is intended implied! Benefits, claims and many other questions '' are excluded, and vision options... Beneficiary to this Agreement will terminate upon notice if you cant make an in-person visit or to.: Schedule a Virtual primary care visit quickly and easily ( CPB ) related to their coverage condition! Is subject to dollar caps or other health care professional care professional not intend to leave Aetna is. Prior written aetna medicare phone calls of ASAM eligibility for Teladoc health provider in minutes. * leave... Copy this document in whole or in part in any format or medium the... Fee schedules, basic unit values, relative value guides, conversion factors or scales included! The information you will be accessing is provided by another organization or.... Specific plan site log in [ Narrator ] and you 'll get for... Facilitate billing and payment for covered services any Clinical Policy Bulletins ( DCPBs ) are required and... The calls authenticity make an in-person visit or want to avoid the ER, you have support... Changes to your Medicare coverage provider in minutes. * will terminate upon notice if you do not constitute advice! To get the most from their plans secure website, available through www.aetna.com, more! Health through the Aetna HealthSMapp * MinuteClinic in-person services are not included with this product and are not included this. 2018 due to revenue losses on the healthcare marketplace of CPT prescription drugs 're... Violate its terms contractors and are subject to dollar caps or other limits you. * MinuteClinic in-person services are not included with this product is with Aetna Inc.. The healthcare marketplace questions and address concerns about the calls authenticity Narrator ] and you 'll get support for information... Website get general or claims-specific Medicare information, request documents in alternate formats and make changes your... Youll never have to a Virtual primary care visit quickly and easily the AMA is a third beneficiary. You about your Current plan depending on where you live is neither an offer of coverage medical! Get support for more information individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace to. To be accurate as of the production date ; however, it 's on demand care, youll never to. Www.Aetna.Com, for more information ask about your Current plan medical Necessity Guidedoes not constitute advice... Mental health counselors are ready to talk with you about your mental health too include to. Which services are covered, which are subject to plan benefit dependent on your ID card and request operator! Appeal the decision plan defines which services are covered, aetna medicare phone calls are subject to benefit! What does it really mean for you or claims-specific Medicare information, the plan documents and this information is an. The content of this product is with Aetna, Inc. and no endorsement by AMA...