A grievance is a type of complaint you make about us or one of our network providers or pharmacies, including a complaint concerning the quality of your care. Already a member? You are now being directed to CVS Caremark site. 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. Medicaid Address and phone number List 1, Medicaid claim submission address List 2. For all other Products Provider Dispute Inquiries (PPO and Commercial HMO plans): Contact the Provider Service Center at 1-888-MD-Aetna (632-3862). Disclaimer of Warranties and Liabilities. Mail to: Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non PO Box 981106 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. The information you will be accessing is provided by another organization or vendor. All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. 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. Electronic claims submission Use our electronic payer ID #60054. The ABA Medical Necessity Guidedoes not constitute medical advice. Federal No Surprises Act. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Health Savings Account Tools and Information. Find a seminar Extra benefits From a 24-hour nurse line to vision and LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). CPT only copyright 2015 American Medical Association. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. BE SURE TO KEEP COPIES OF CLAIMS SUBMITTED FOR YOUR FILES, MAIL CLAIMS TO: In case of a conflict between your plan documents and this information, the plan documents will govern. You are now being directed to the CVS Health site. 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. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. 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. 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. Simply share your question or comment with us on our students-only contact form. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Contact us by phone. The Provider Service Center helps with contracting, patient services, precertification and many other questions. HMO and Medicare Advantage - 1-800-624-0756 (TTY: 711) Indemnity and PPO-based plans - 1-888-MD AETNA ( 1-888-632-3862) (TTY: 711) Voluntary plans - 1-888-772-9682 (TTY: 711) Worker's comp - 1-800-238-6288 (TTY: 711) Treating providers are solely responsible for medical advice and treatment of members. 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. To learn more about submitting COB claims electronically, go to www.aetna.com/provider/ecob. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. All Rights Reserved. NAIC Coordination of Benefits Policy. 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. 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 Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. Independent retail pharmacies can fill out the form at the link below. WebEmailing us Faxing us at 1-844-209-2060 EFT form (PDF) Youll want to allow up to 15 days for us to process your EFT form. Do you want to continue? When billing, you must use the most appropriate code as of the effective date of the submission. You are a COBRA participant in the ExxonMobil Medicare Supplemental Plan. Please be sure to add a 1 before your mobile number, ex: 19876543210. Biometric Screenings. * Need more help with electronic claims submissions? If you are a nonparticipating provider in our Medicare PPO plan. Aetna Medicare Grivance submission address. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. WebAetna Better Health Illinois Claims Mailing Address Health (3 days ago) Web (3 days ago) WebAetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Aetna meritain claims address and Phone number: https://www.health-improve.org/aetna-better-health-illinois-claims-mailing-address/ This information is neither an offer of coverage nor medical advice. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. A complete application is the first step in the enrollment process When assisting your clients with their application, youre responsible for answering their questions and ensuring all required information on the enrollment form is complete. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. This type of complaint does not involve coverage or payment determinations. 800-566-9311Aetna coresource claims address and Phone NumberAetna, Inc. P O Box 981107El Paso, TX 79998-1107800-793-8616Aetna credentialing phone number800-353-1232if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'medicalbillingrcm_com-medrectangle-4','ezslot_11',340,'0','0'])};__ez_fad_position('div-gpt-ad-medicalbillingrcm_com-medrectangle-4-0'); Aetna claim address and Aetna phone numbers are very important to handling denials, AR follow-up and claim submission. 79998-1106, Aetna Student HealthSM To help us direct your question or comment to the correct area, please select from oneof the categories below. Lexington, KY Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. If you find anything not as per policy. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 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. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Health benefits and health insurance plans contain exclusions and limitations. 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 five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. AETNA 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. BOX 14586 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. 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. Just log in to your member account to send us an email or chat online. Or, call your vendors customer service help line. 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). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. We're here to help. When you have all the information necessary, mail your claim to the Aetna office shown on the top of this form. This is the phone number for the Corporate Contact Center. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Aetna Call Aetna Member Services: 1-855-339-9731 (TTY: 711) Monday through Friday, 7 AM to 5 PM CT Health The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Please log in to your secure account to get what you need. 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. Your benefits plan determines coverage. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna has more address but usually accept all the claims whatever address you submit from the below list. For language services, please call the number on your member ID card and request an operator. Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for 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 I practice independently and I want to contract with Aetna. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. El Paso, TX 79998-1106. WebMiddle East AAA RI claims: ri.claims@alainahlia.aetna.com Singapore: IGSGclaims@aetna.com Thailand: Thailandclaims@nzihealthcare.com UK: 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. 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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 log in to your secure account to get what you need. Paper claims submission If necessary, use the following claims billing addresses. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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. Some subtypes have five tiers of coverage. WebTo contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM5PM (MondayThursday), 9AM5PM (Friday). EL Paso , TX 79998-1204, Paper Claims HMO & PPO Products Mail claims to:
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