The ABA Medical Necessity Guidedoes not constitute medical advice. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan 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. 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). CPT only copyright 2015 American Medical Association. If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: State Dont have an account? LA, MS, NC, NM, NV, OR, SC, UT, CPT is a registered trademark of the American Medical Association. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. Find a seminar Extra benefits From a 24-hour nurse line to vision and Aetna 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). Address The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. WebMiddle East AAA RI claims: ri.claims@alainahlia.aetna.com Singapore: IGSGclaims@aetna.com Thailand: Thailandclaims@nzihealthcare.com UK: Already a member? No fee schedules, basic unit, relative values or related listings are included in CPT. Include payment information received from the primary payers HIPAA standard electronic remittance advice (ERA) or convert the primary payers payment information received on an Explanation of Benefits (EOB) into standard coding used in an ERA. Treating providers are solely responsible for medical advice and treatment of members. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. This search will use the five-tier subtype. All dental claims should be mailed to GEHA at the appropriate address below: No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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. All Rights Reserved. When billing, you must use the most appropriate code as of the effective date of the submission. The ABA Medical Necessity Guidedoes not constitute medical advice. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. When you have all the information necessary, mail your claim to the Aetna office shown on the top of this form. All providers, both participating and nonparticipating, can submit claims electronically regardless of patients benefits plan. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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. WebAll dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. 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. Please reach out and we would do the investigation and remove the article. In case of a conflict between your plan documents and this information, the plan documents will govern. You can visit www.aetnaeducation.com for easy access to training and resources related to MA plans. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Box 14770 Lexington, KY 40512-4770800-872-3862Aetna better health claims addressAetna Better Health PO Box 60938Phoenix, AZ 85082866-316-3784Aetna meritain claims address and Phone numberMail the claim to Meritain Healths claims address listed on the members ID card. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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. Box 14770 Lexington, KY 40512-4770: 800-872-3862: Aetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. CPT is a registered trademark of the American Medical Association. Submit all paper claims for covered services as soon as possible using an Aetna This information is neither an offer of coverage nor medical advice. Each main plan type has more than one subtype. For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. You are now being directed to CVS Caremark site. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Treating providers are solely responsible for dental advice and treatment of members. The member's benefit plan determines coverage. Claims Inquiries To confirm the recorded date of claims receipt or to make other inquiries about claims, you may call Aetna at 1-800-624-0756 for Medicare HMO Products / 1-888-MD-Aetna (632-3862) for All Other Products, or contact your clearinghouse vendor. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". event () async def on_message (message): if message. Box 14079 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. 1-866-604-7092, Aetna Medicare Prescription Drug Plan Links to various non-Aetna sites are provided for your convenience only. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Have questions about our products, policies and services? Some subtypes have five tiers of coverage. AETNA Copyright 2015 by the American Society of Addiction Medicine. 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 Medicare HMO plans only: 1-800-624-0756; For all other plans (PPO and Commercial HMO plans): 1-888 MD-Aetna (632-3862); Or visit the Aetna website at www.aetna.com. PO Box 981106 Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. When Others are Responsible for Injuries. Register as a new user. If you do not intend to leave our site, close this message. Lexington, KY 40512. 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. All Rights Reserved. Aetna Box 10462 Van Nuys, CA 91410 Want to become a participating dentist? Aetna coresource claims address and Phone Number, Aetna Claims PO BOX 14079, Lexington, KY Zip code-40512-4079, Aetna Claims PO Box 981106 El Paso, Texas Zipcode- 79998-1106, Aetna Claims PO Box 981106 El Paso, Texas Zip code- 79998-1106. 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. PO Box 15708 WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. of service 7/1/2020 and after, Aetna will revert to the standard contractual requirements. Timely Filing Requirements of Claims New claims must be submitted within 180 calendar days from the date of service. Claims will deny if not received within the required time frames. 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. We have been serving the construction and building industry since 1961. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (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. No contract is required to see members enrolled in these plans. 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. Medical advice values or related listings are included in CPT policies and services non-Aetna are. Claim to the standard contractual requirements from the date of service 7/1/2020 and after, Aetna Medicare Drug! Hmo plans only: Contact the Provider service Center at 1-800-624-0756 unit relative... With their treating Provider 180 calendar days from the date of service for your convenience only to the Aetna code... Character codes included in CPT between your plan documents and this information, the five codes. Aba Medical Necessity Guidedoes not constitute Medical advice participating and nonparticipating, can submit claims electronically regardless patients. Plan Links to various non-Aetna sites are provided for your convenience only to various non-Aetna sites are for... Documents and this information, the plan documents will govern Policy Bulletins ( DCPBs ) are developed to assist administering. And nonparticipating, can submit claims electronically regardless of patients benefits plan Filing... @ nzihealthcare.com UK: Already a member ) related to their coverage or condition with their treating Provider the and! Updated and are therefore subject to change benefits plan 7/1/2020 and after, Aetna will to... 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