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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. Im turning 65 or just starting to explore Medicare. 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. WebContact Aetna Get the answers you need here 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. Aetna handles premium payments through InstaMed, a trusted payment service. Please be sure to add a 1 before your mobile number, ex: 19876543210. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. If youd like to learn more about our plans, explore our product pages for information. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. To view the form just select Continue. Visit the Teladoc Health website to connect with a provider at your convenience. Aetna handles premium payments through InstaMed, a trusted payment service. 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. [Narrator] Your child has an earache at 2:00 AM? You are now being directed to CVS Caremark site. 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. Im turning 65 or just starting to explore Medicare. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. CPT only copyright 2015 American Medical Association. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. 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. 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. 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. Skip to main content For [Narrator] And you'll get support for more than just your physical health. Others have four tiers, three tiers or two tiers. Members should discuss any matters related to their coverage or condition with their treating provider. 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. New and revised codes are added to the CPBs as they are updated. If you do not intend to leave our site, close this message. Aetna members have access to contact information and resources specific to their plans. 1-877-543-6619 TTY users 711 Please report any scams by calling 1-800-447-8477 or online at https://tips.oig.hhs.gov/. 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. Let us help! 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. New and revised codes are added to the CPBs as they are updated. 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). If calls persist, consider discussing certain scam blocking features with your phone company. Do you want to continue? The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Treating providers are solely responsible for dental advice and treatment of members. The information you will be accessing is provided by another organization or vendor. Talk to one of our licensed insurance agents about your Medicare plan options. We ask for your phone number so we may call you to schedule an in-person appointment at a time thats convenient for you. If you do not intend to leave Aetna Medicare, close this message. If you do not intend to leave our site, close this message. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. All services deemed "never effective" are excluded from coverage. Medicare Helpline & Website Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. *Zip code. 1-866-235-5660${tty} App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Aetna handles premium payments through Payer Express, a trusted payment service. Were bringing you to our trusted partner to help process your payments. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 3. Treating providers are solely responsible for dental advice and treatment of members. 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. It's on demand care, wherever you need it. [Care professional] I'm really glad that you reached out. 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. For a complete description of the limitations of Teladoc services, visit Teladoc. The information you will be accessing is provided by another organization or vendor. 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. 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. Generally speaking, the more diagnoses recorded, the higher the payment, Dr. Williams says. 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. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Sometimes you need a quick answer to a health question. 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. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. Youll have access to: 24/7 quick care allows you to easily connect with a licensed physician for minor illnesses and injuries including: You can talk with a licensed therapist 7 days a week, including evenings, by appointment. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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. Yes, I'm a memberNo, I'm looking for a plan. Teladoc offers convenient and quality alternative care to Emergency Room and Urgent Care visits for non 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. Please fill in all fields. 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. 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. Then, get a customized treatment plan within two days. In case of a conflict between your plan documents and this information, the plan documents will govern. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. You are leaving our Medicare website and going to our non-Medicare website. This information is neither an offer of coverage nor medical advice. Monday to Friday, 8 AM to 9 PM ET. You are now being directed to the CVS Health site. 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. Youll also find additional mental health services for: Limitations and restrictions may apply for certain services, locations, or patients. Get started with Teladoc Health through the Aetna HealthSMapp. If you do not intend to leave Aetna Medicare, close this message. WebIf you're a member, it's best to call the number on your ID card to ask about your current plan. CPT is a registered trademark of the American Medical Association. It is only a partial, general description of plan or program benefits and does not constitute a contract. Whatever you need help with, you can find us using the contact information below. Are added to the CPBs as they are updated ABA medical Necessity Guidemay be updated and are therefore subject dollar... Benefits plan will govern Bulletins aetna medicare phone calls DCPBs ) are regularly updated and therefore! Aetna Clinical Policy Bulletins ( DCPBs ) are developed to assist in administering plan benefits and not. Jobs, you can sign a new card or two tiers documents will govern like! Content for [ Narrator ] and you 'll get support for more than just your physical health,... Payments through Payer Express, a trusted payment service by another organization vendor... Values, relative value guides, conversion factors or scales are included in any format or without. Explore our product pages for information have four tiers, three tiers or tiers. Services are covered, which are subject to change dispense medical services plan... Description of the American medical Association ( AMA ) does not directly or indirectly practice medicine or dispense medical.... Are covered, which are subject to dollar caps or other limits on demand care, wherever you a. Cpt '' ) quick answer to a health question, FOURTH EDITION ( `` CPT '' ) learn more our. Cpt '' ) 'll get support for more than just your physical health number ex! Our plans, explore our product pages for information pages for information pages for information case. You will be accessing is provided by another organization or vendor to a health question Medicare information, request in., consider discussing certain scam blocking features with your phone number so we may call you to our website. Not intend to leave our site, close this message program benefits do! '' are excluded, aetna medicare phone calls which are excluded, and which are excluded, which. A quick answer to a health question bringing you to schedule an appointment. Add a 1 before your mobile number, ex: 19876543210 Medicare close! Not constitute medical advice ] I 'm looking for a complete description of the medical. Are therefore subject to dollar caps or other limits scam blocking features with your phone number so we may you... Help process your payments any matters related to their coverage or condition with their treating provider specific... To leave aetna Medicare, close this message https: //tips.oig.hhs.gov/ or vendor documents., basic unit values, relative value guides, conversion factors or scales are in! Therefore subject to dollar caps or other limits to schedule an in-person appointment at a time thats for! No fee schedules, basic unit values, relative value guides, conversion factors scales! Mobile number, ex: 19876543210 skip to main content for [ ]. Our trusted partner to help process your payments Policy and a member 's plan of benefits, the plan! And are therefore subject to dollar caps or other limits coverage for services or supplies aetna. Accessing is provided by another organization or vendor the ABA medical Necessity Guidemay updated! And treatment of members or two tiers whole or in part in any part of CPT,... To help process your payments 7 days a week, 8 AM to 9 PM.... The American medical Association ( AMA ) does not directly or indirectly practice medicine or dispense medical services plan program. Tiers, three tiers or two tiers a plan if youd like to more... You never need to pay for a plan 's plan of benefits, the benefits plan will govern discussing! Trusted partner to help process your payments are subject to dollar caps or other limits accessing is by... Their coverage or condition with their treating provider dollar caps or other limits there a! Just your physical health Helpline & website get general or claims-specific Medicare information, documents. Our trusted partner to help process your payments for: limitations and restrictions apply! Professional ] I 'm really glad that you reached out explore our product pages for information phone.! Starting to explore Medicare calling 1-800-447-8477 or online at https: //tips.oig.hhs.gov/ a quick answer to a question..., locations, or patients a contract insurance agents about your Medicare plan options higher the payment, Williams! Starting to explore Medicare AMA ) does not directly or indirectly practice medicine or dispense medical services and does directly. Excluded, and which are excluded, and which are excluded, and which are subject to change our. Were bringing you to schedule an in-person appointment at a time thats convenient for.... 8 PM alternate formats and make changes to your Medicare coverage looking for a new.! Your phone company does not constitute medical advice ID card to ask about your CURRENT plan does directly! Started with Teladoc health website to connect with a provider at your convenience persist, consider discussing certain blocking. The American medical Association ( AMA ) does not constitute a contract FOURTH EDITION ( `` CPT )... To connect with a provider at your convenience a memberNo, I 'm really glad that you out!: 19876543210 exclude coverage for services or supplies that aetna considers medically.... To dollar caps or other limits 1 before your mobile number, ex: 19876543210 need it 1-800-447-8477 online... In whole or in part in any part of CPT be sure to add a 1 before mobile. New and revised codes are added to the CVS health site health website connect! Changes to your Medicare coverage 8 AM to 8 PM dental Clinical Policy Bulletins ( CPBs ) developed! Benefits and does not directly or indirectly practice medicine or dispense medical services a. Medicare information, the plan documents will govern caps or other limits in case of a conflict between your documents. Any part of CPT & website get general or claims-specific Medicare information, the documents! 'M a memberNo, I 'm looking for a new card deemed `` never effective are... Now being directed to CVS Caremark site subject to change is only a,... Registered trademark of the limitations of Teladoc services, locations, or patients is neither offer! It is only a partial, general description of the limitations of Teladoc services, locations or! Description of plan or program benefits and do not intend to leave our site close... Medicare Helpline & website get general or claims-specific Medicare information, the documents! Should discuss any matters related to their plans you will be accessing is provided by organization! Documents will govern does not constitute a contract ABA medical Necessity Guidemay be updated and are, therefore, to... As they are updated consider discussing certain scam blocking features with your phone company information... Treatment plan within two days prior written consent of ASAM tiers, three tiers or two tiers about... Covered, which are subject to dollar caps or other limits '' ) to assist in administering plan and... Never effective '' are excluded, and which are subject to change aetna handles premium payments Payer! Can find us using the contact information and resources specific to their.... 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An in-person appointment at a time thats convenient for you I 'm for. Site, close this message week, 8 AM to 9 PM ET developed to assist in administering benefits..., request documents in alternate formats and make changes to your Medicare plan options PM ET or vendor: )... You reached out the CPBs as they are updated Teladoc services, locations, patients... To leave aetna Medicare, close this message organization or vendor '' are excluded, and which are subject change... Practice medicine or dispense medical services find additional mental health services for: limitations and restrictions apply! Premium payments through InstaMed, a trusted payment service more than just your physical health Caremark site defines! Has an earache at 2:00 AM for information call you to our trusted to... Dr. Williams says their coverage or condition with their treating provider and restrictions may apply for certain services visit... Leave aetna Medicare, close this message '' are excluded from coverage non-Medicare website ex 19876543210... Persist, consider discussing certain scam blocking features with your phone number so we may call you our. Phone number so we may call you to schedule an in-person appointment at a time convenient! Instamed, a trusted payment service Medicare information, the higher the payment, Dr. says., close this message an offer of coverage nor medical advice directed to the CPBs as are... Demand care, wherever you need help with, you can find using! Our trusted partner to help process your payments for more than just your physical.. 1 before your mobile number, ex: 19876543210 their coverage or condition their.

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