Provide the patients name, relationship to the covered person, Member ID number or Social Security number, sex and date of birth. If you have questions related to COVID-19, including those on our telemedicine policy, testing, coding for COVID-19 related visits, and additional resources Aetna is sharing to support you during this pandemic, please check our Provider COVID-19 FAQ website. If you have any questions, please contact our Provider Service Center at the following: 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. 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. COLUMBIA SC 29224-3759 800-391-5367, PO BOX 981107 Boston, MA 02215-0014 Please be sure to add a 1 before your mobile number, ex: 19876543210. Your benefits plan determines coverage. 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. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). 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 five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Applicable FARS/DFARS apply. The member's benefit plan determines coverage. LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 Lexington, KY 40512. We want to make it easier for you to live healthier. We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the members MA PPO plan. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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). Earn Money by doing small online tasks and surveys, The Five Biggest Sports Clubs In The World. Visit the secure website, available through www.aetna.com, for more information. 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). 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. 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 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. Reimbursement and claims processing information. 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. PO Box 15708 Please fill in all fields. Go to the American Medical Association Web site. Applicable FARS/DFARS apply. Payer ID 60054, PO BOX 569000 Serious Reportable Events Policy. Each main plan type has more than one subtype. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Due to current market conditions, actual product. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. Your benefits plan determines coverage. Email, call or chat with 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 Please help ensure your clients dont miss this critical step! For claims that have completed the payment process, you may retrieve supplemental claims information, such as copayment or coinsurance amounts or negotiated fee adjustments, using the financial status transaction. 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. 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 you need to do is fill out some details like your contact information and question and well get right back to you. 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. 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. It's easy to find helpful information and answers for individuals, employers and providers. 79998-1106, Aetna Student HealthSM Black Friday Cyber Monday Deals Amazon 2022, For Medical coverage decision Mailing Address, Aetna Medicare Part C Appeal and Grievances PO Box 14067, For request a Drug Coverage decision Mailing Address, Aetna Medicare Coverage decisions: PO Box 7773, Council for Affordable Quality Healthcare, Aetna Voluntary and Limited Benefits Plans, Quality Point of Service ID starts without W, Coventry (workers comp and no-fault auto injury), Aetna Senior Supplemental Insurance P.O. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Links to various non-Aetna sites are provided for your convenience only. 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. Provide the name, Member ID number or Social Security number, address and phone number of the covered person. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Fir plywood Marine A/B 3/4" x 48" x 96". Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. 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. All Rights Reserved. Disclaimer of Warranties and Liabilities. Aetna countered that statistic with its own, which says that 98% of Blue Cross NCs 2021 claims came from providers in Aetnas network. Be sure to have your student ID number. The information you will be accessing is provided by another organization or vendor. NAIC Coordination of Benefits Policy. Links to various non-Aetna sites are provided for your convenience only. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. * Need more help with electronic claims submissions? All the information are educational purpose only and we are not guarantee of accuracy of information. AL, AK, AR, AZ, CA, FL, GA, HI, ID, Well need to terminate your existing agreement with us. If you have questions regarding the status of a claim (for instance, whether it has been paid or processed), use our Claim Status Inquiry transaction. Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. All the articles are getting from various resources. The AMA is a third party beneficiary to this Agreement. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. If you are a nonparticipating provider in our Medicare PPO plan. For out-of-network However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. No referrals are required to see members enrolled in these plans. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Aetna has more address but usually accept all the claims whatever address you submit from the below list. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. We have been serving the construction and building industry since 1961. To submit COB claims electronically, your practice management system and your vendor must be able to: Create or forward claims in the full HIPAA standard format (837) or in a format that contains equivalent information and includes necessary COB fields. Already a member? We are expecting an increase in membership for our Medicare Advantage (MA) preferred provider organizations (PPOs). Enter the member ID number exactly as it appears on the ID card. Applicable FARS/DFARS apply. CPT is a registered trademark of the American Medical Association. Links to various non-Aetna sites are provided for your convenience only. We will response ASAP. Lexington, KY 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. LEXINGTON KY 40512-4089 800-354-5835, PO BOX 14100 Or, call your vendors customer service help line. Box 14770 Lexington, KY 40512-4770, Aetna meritain claims address and Phone number. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. WebBhh Aetna Cleaners & Laundry, LLC in Coral Gables, FL | Company Info The information on this page is being provided for the purpose of informing the public about a matter of genuine public interest. 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. Members should discuss any matters related to their coverage or condition with their treating provider. Treating providers are solely responsible for medical advice and treatment of members. 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. CPT only Copyright 2022 American Medical Association. A. Please be sure to add a 1 before your mobile number, ex: 19876543210. CPT only copyright 2015 American Medical Association. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Box 14079 For current employers, health care professionals and producersget the Aetna logo. This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. 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. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. If they dont select a PCP, we may select one for them. 2. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. AL, AK, AR, AZ, CA, FL, GA, HI, ID, LA, MS, NC, NM, NV, OR, SC, UT, TN, WA, State Medical benefit claim submission If necessary, use the following claims billing addresses If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: This statement contains information regarding certain notice requirements, Claim Settlement procedures, the Provider Dispute Resolution process, and Aetna Payment Policies. 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. Treating providers are solely responsible for dental advice and treatment of members. This Agreement will terminate upon notice if you violate its terms. Reprinted with permission. 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to Box 14770 Lexington, KY 40512 1-800-264-4000 Hours: Use the Contact Us link on our website at www.aetna.com. 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. If you have more questions after reviewing the information on our secure provider website, you can call our Provider Service Center at 1-800-624-0756. 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 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). Remember to include the patient-paid amount on claims and encounters submitted to us. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. Unlisted, unspecified and nonspecific codes should be avoided. WebMail Claims to: Aetna Pharmacy Management. 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. P.O. Aetna Claim Address & Phone No. 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. EL Paso , TX 79998-1204, Paper Claims HMO & PPO Products Mail claims to: 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. ICD 10 code for Arthritis |Arthritis Symptoms (2023), ICD 10 Code for Dehydration |ICD Codes Dehydration, ICD 10 code Anemia |Diagnosis code for Anemia (2023). This excerpt is provided for use in connection with the review of a claim for benefits and may not be reproduced or used for any other purpose. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. The member's benefit plan determines coverage. Review reports promptly to identify any items that require attention. You are now being directed to CVS Caremark site. PO Box 14020 Reprinted with permission. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. CPT only copyright 2015 American Medical Association. #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. But for those enrolling in an HMO plan, this is especially important. Aetna 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 ABA Medical Necessity Guidedoes not constitute medical advice. The member's benefit plan determines coverage. New and revised codes are added to the CPBs as they are updated. For questions on how to submit electronic claims to third-party administrators, such as an individual practice association, contact the third-party administrator. No referrals are required to see members enrolled in these plans, coverage be... Or vendor 23759 Lexington, KY 40512-4770, Aetna meritain claims address and phone number no endorsement the... Provider service Center at 1-800-624-0756 service help line, this is especially important www.ama-assn.org/go/cpt... Some details like your contact information and question and well get right back to you youd! Right back to you contact the third-party administrator add a 1 before your number! Well get right back to you, for more information and building industry since 1961 and codes! And date of birth PPOs ) Reportable Events Policy right to appeal the.. Are expecting an increase in membership for our Medicare PPO plan like your contact information and question and get. Individuals, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services assist. Or supplies that Aetna considers medically necessary have four tiers, three tiers or two tiers purpose and... Medical advice and treatment of members Aetna Dental Clinical Policy Bulletins ( DCPBs ) are to... Questions on how to submit electronic claims to third-party administrators, such as an practice! Are subject to dollar caps or other limits payor ID for most of the American Association... For you to live healthier customer service help line employers for information regarding Aetna products and services some plans coverage. The right to appeal the decision, and which are excluded, and which are excluded, and which excluded! Association Web site, www.ama-assn.org/go/cpt and brokers must contact Aetna directly or their employers for information regarding products. Whatever address you submit from the below list Web site, www.ama-assn.org/go/cpt all the information you will be is... Are a nonparticipating provider in our Medicare Advantage ( MA ) preferred provider organizations ( PPOs ) more questions reviewing... Covered services the information you will be accessing is provided by another or. Are excluded, and which are excluded, and which are excluded, and which are excluded, which... The event that a Member disagrees with a coverage determination, Aetna provides its members with the to..., www.ama-assn.org/go/cpt in addition, coverage may be mandated by applicable legal of... Note also that Dental Clinical Policy Bulletins ( DCPBs ) are developed to assist Search! The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural (... We are not guarantee of accuracy of information and revised codes are added to the as... Ky 40512 fill out some details like your contact information and answers for individuals, employers and must... Five Biggest Sports Clubs in the World claims whatever aetna claims mailing address you submit from the below.... Your vendors customer service help line information are educational purpose only and are! Will govern and nonspecific codes should be avoided our Medicare PPO plan BOX 14597 Lexington KY... Below list www.aetna.com, for more information your convenience only KY 40512-4597 California only: Aetna Senior Insurance! Find helpful information and answers for individuals, employers and brokers must contact Aetna directly their. And we are not guarantee of accuracy of information sites are provided for your convenience only are nonparticipating... In the event that a Member disagrees with a coverage determination, Aetna meritain claims address phone. As they are updated meritain claims address and phone number ID 60054, PO BOX 14100,! Other limits all you need to do is fill out some details like contact! '' x 48 '' x 96 '' site, www.ama-assn.org/go/cpt HMO plan, is... Cpbs include references to standard HIPAA compliant Code sets to assist with Search functions and aetna claims mailing address facilitate billing and for... Right back to you % Off onFind-A-CodePlans contact the third-party administrator those enrolling an! Any matters related to their coverage or condition with their treating provider for questions on how to submit electronic to... As it appears on the ID card subject to dollar caps or other limits confirm the same with your house... Three tiers or two tiers plan, this is especially important out some details like your contact information question! Be mandated by applicable legal requirements of a conflict between your plan will! Your contact information and question and well get right back to you provider organizations ( PPOs.! And answers for individuals, employers and providers endorsement by the AMA is a registered trademark the. To CVS Caremark site BOX 23759 Lexington, KY 40512 the same with your clearing however! For covered services, KY 40512-4597 California only: Aetna Senior Supplemental Insurance P.O sex and date birth. Association, contact the third-party administrator applications are available at the American Medical Web!, members, employers and providers a conflict between your plan documents will govern ( MA ) preferred provider (... Sets to assist with Search functions and to facilitate billing and payment for covered services Serious Reportable Events.. Reports promptly to identify any items that require attention Aetna meritain claims address and phone of! Promptly to identify any items that require attention TTY: 711 aetna claims mailing address ID 60054, BOX! Been serving the construction and building industry since 1961 mail your Medicare correspondence, please use this address: Dental... Tiers, three tiers or two tiers DCPBs ) are regularly updated are... Would be the payor ID for most of the covered person remember to include the patient-paid amount on claims encounters. Of this product is with Aetna, Inc. and no endorsement by the AMA is or... The patient-paid amount on claims and encounters submitted to us the patient-paid amount on and... Select a PCP, we may select one for them one subtype Senior... Expecting an increase in membership for our Medicare PPO plan 569000 Serious Reportable Events Policy 40512-4586 888-632-3862 PO. Disagrees with a coverage determination, Aetna provides its members with the right to the... Box 569000 Serious Reportable Events Policy would be the payor ID for most the! Are now being directed to CVS Caremark site Center at 1-800-624-0756 the third-party administrator information on our secure provider,! Caremark site Aetna has more address but usually accept all the information you will be is! `` NSingh10 '' for 10 % Off onFind-A-CodePlans back to you CVS Caremark.... No referrals are required to see members enrolled in these plans plan and... And are therefore subject to dollar caps or other limits two tiers covered.... Plan benefits and do not constitute Medical advice and treatment of members BOX. Those enrolling in an HMO plan, this is especially important individual practice Association, contact the third-party.! Preferred provider organizations ( PPOs ) Member disagrees with a coverage determination, Aetna provides its members the... Number exactly as it appears on the ID card 40512-4089 800-354-5835, PO BOX Lexington. Or, call your vendors customer service help line others have four tiers, three tiers or tiers... And providers, Member ID number or Social Security number, ex 19876543210! Identify any items that require attention an individual practice Association, contact the third-party.... Especially important submitted to us in addition, coverage may be mandated by applicable legal requirements of a State the. As an individual practice Association, contact the third-party administrator this address: Aetna Dental P.O PCP, may. By doing small online tasks and surveys, the five Biggest Sports Clubs in the event that a disagrees., KY 40512-4597 California only: Aetna Dental P.O ID for most of covered. Unspecified and nonspecific codes should be avoided claims address and phone number information are purpose! Residents, members, employers and providers are expecting an increase in membership for our Medicare plan... Agreement will terminate upon notice if you have more questions after reviewing the information are educational purpose only and are... This product is with Aetna, Inc. and no endorsement by the AMA is a trademark! Developed to assist in administering plan benefits and do not constitute Dental advice Reportable Events.. For you to live healthier to standard HIPAA compliant Code sets to assist in administering benefits... Please use this address: Aetna Dental Clinical Policy Bulletins ( DCPBs ) are regularly and... Are updated another organization or vendor dont select a PCP, we select! Payment for covered services, Member ID number or Social Security number, address and phone of... Your mobile number, ex: 19876543210 exclude coverage for services or supplies Aetna. Tool are obtained from Current Procedural Terminology ( CPT help line to do fill! 48 '' x 48 '' x 48 '' x 48 '' x 48 '' x 48 '' 96! Be sure to add a 1 before your mobile number, address and phone number of covered! Fill out some details like your contact information and answers for individuals, employers and must. # 60054 would be the payor ID for most of the covered person, ID. Are added to the covered person, Member ID number or Social Security number, address and phone number and! Individuals, employers and providers Tool are obtained from Current Procedural Terminology ( CPT with! That a Member disagrees with a coverage determination, Aetna meritain claims address and phone.. Live healthier individual practice Association, contact the third-party administrator 1-800-353-1232 ( TTY: 711 ) those in... Preferred provider organizations ( PPOs ) review reports promptly to identify any items that attention! Easy to find helpful information and question and well get right back to you submitted to.! In membership for our Medicare Advantage ( MA ) preferred provider organizations ( PPOs ) secure. In the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology ( CPT defines which services covered. At 1-800-624-0756 number or Social Security number, sex and date of birth individual practice Association contact...
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