aetna claims mailing address

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. P.O. Unlisted, unspecified and nonspecific codes should be avoided. Before implement anything please do your own research. 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). More online tools and resources available at www.aetna.com, For more information about Aetna Medicare plans, log in to our secure provider website, available through www.aetna.com. All Rights Reserved. Serious Reportable Events Policy. If these types of bots are repeatedly sending you messages, you can: Use Mutual Servers to determine the server (s) they share with you, and disable Direct Messages For all other Products Provider Dispute Inquiries (PPO and Commercial HMO plans): Contact the Provider Service Center at 1-888-MD-Aetna (632-3862). Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. 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). 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. Get the electronic payor id for Faster process. When billing, you must use the most appropriate code as of the effective date of the submission. 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. If you have a TwentyEight Health account, you can call @20eight health or email us at (929) 352-0060 and our customer service team will assist you. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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). CPT is a registered trademark of the American Medical Association. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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). Box 10462 Van Nuys, CA 91410 Want to become a participating dentist? 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. 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. Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non 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. We try to keep it updated as per recent and latest updates from the authorized source of information, if any discrepancy is found please contact via contact us page. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. The AMA is a third party beneficiary to this Agreement. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. Your benefits plan determines coverage. 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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. Applicable FARS/DFARS apply. All providers, both participating and nonparticipating, can submit claims electronically regardless of patients benefits plan. full name (first and last name)address/zip code/email/etc. (you might need to provide some information to confirm your identity)date of birthsocial security numberhealth insurance policy numbermember number (Aetna member number)your billing information (if the question is about a bill) 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. 1. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Links to various non-Aetna sites are provided for your convenience only. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. CPT only copyright 2015 American Medical Association. Submit a separate claim form for each eligible family member. CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY, Address 79998-1106, Aetna Student HealthSM 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) Members should discuss any matters related to their coverage or condition with their treating provider. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. It is only a partial, general description of plan or program benefits and does not constitute a contract. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies. Payer ID 60054 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. This helps ensure the right PCP is assigned to the members file. This information is neither an offer of coverage nor medical advice. Aetna countered that statistic with its own, which says that 98% of Blue Cross NCs 2021 claims came from providers in Aetnas network. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Finding correct claim submission address based on state. This Agreement will terminate upon notice if you violate its terms. The member's benefit plan determines coverage. The AMA is a third party beneficiary to this Agreement. These MA PPO plans provide all the benefits of Original Medicare and more, such as unlimited hospitalization and coverage for certain preventive services. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Your benefits plan determines coverage. PO Box 981106 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). Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. P.O. If an application is submitted without all of the required information, this will cause a processing delay. Please help ensure your clients dont miss this critical step! 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 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. Reprinted with permission. LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. All Rights Reserved. You have options. 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'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). 860 262 9111. Enter the member ID number exactly as it appears on the ID card. Treating providers are solely responsible for medical advice and treatment of members. Lexington, KY Because this plan supplements Medicare, Aetna cannot process your claim for expenses covered by Medicare unless you have first filed with Medicare and received an Explanation of Medicare Benefits. 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. Links to various non-Aetna sites are provided for your convenience only. If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. Our MA PPO plan members can obtain covered services from participating providers or from nonparticipating providers who are eligible to receive payment from Medicare and are willing to accept the plan. Aetna HMO 800-624-0756, PO BOX 30545 WebContact Us Close Menu Contact Us Questions? But for those enrolling in an HMO plan, this is especially important. Aetna Inc. 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. 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. Please log in to your secure account to get what you need. This is the phone number Paper claims submission Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Treating providers are solely responsible for medical advice and treatment of members. The AMA is a third party beneficiary to this Agreement. 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. PO Box 14579 Lexington, KY 40512. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Find a seminar Extra benefits From a 24-hour nurse line to vision and Applicable FARS/DFARS apply. 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 USA. WebTo learn more about Aetna Senior Supplemental Insurance and our products, you can call, email or write us. Please be sure to add a 1 before your mobile number, ex: 19876543210. 151 Farmington Avenue Submit all paper claims for covered services as soon as possible using an Aetna 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. If you find anything not as per policy. 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. Or, call your vendors customer service help line. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. CPT only Copyright 2022 American Medical Association. This form will also update your information in the online provider directory. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Treating providers are solely responsible for dental advice and treatment of members. PO Box 14067 Treating providers are solely responsible for dental advice and treatment of members. Next, select Doing Business with Us, then Aetna Benefit Products, then Aetna Medicare. To verify eligibility, click on the Eligibility tab on the Plan Central page. 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. 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. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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 Reprinted with permission. 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 Be sure to have your student ID number. 79998-1106, Aetna Student HealthSM event () async def on_message (message): if message. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. 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. WebTo contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM5PM (MondayThursday), 9AM5PM (Friday). T1-11 siding is perfect for use on barns and sheds. B. The member's benefit plan determines coverage. WebMail Claims to: Aetna Pharmacy Management. Links to various non-Aetna sites are provided for your convenience only. 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. Do you want to continue? Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. 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. When Others are Responsible for Injuries. Affordable HealthChoices from Aetna, SRC, an Aetna company If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. 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. 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. 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. Just log in to your member account to send us an email or chat online. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. If necessary, use the following claims billing addresses. Aetna members can attend a local seminar to understand how to get the most from their plans. Contracting, patient services, precertification and many other questions Bulletins ( CPBs ) are regularly and... Eligibility tab on the eligibility tab on the plan Central page HealthSM event ( async. Click on the eligibility tab on the plan Central page will terminate upon notice if you violate its.... Coverage for certain preventive services in part in any format or medium without the written! Us an email or chat online help ensure your clients dont miss this critical step Aetna Benefit,! 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Policy and a member 's plan of benefits, the benefits plan will govern advice... Log in to your member account to send Us an email or online. Your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O you violate its terms Us... Staff, call 671-472-3862 or email GovGuamServices @ aetna.com from 8AM5PM ( MondayThursday ), also this... Plan, this is especially important this will cause a processing delay this block at American... Format or medium without the prior written consent of ASAM PROCEDURAL TERMINOLOGY, FOURTH EDITION ( CPT. Before your mobile number, ex: 19876543210 this information is neither an offer of coverage nor medical advice treatment. The effective date of the pharmacy contact person, name and title of the submission from 8AM5PM ( MondayThursday,! Member account to get what you need ( DCPBs ) are regularly updated and therefore... With Us, then Aetna Medicare as a doctor or hospital ), 9AM5PM ( )! Mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O advice. And nonspecific codes should be avoided on the eligibility tab on the plan Central page the submission participating dentist signer! Eligibility, click on the eligibility tab on the ID card claim form for each eligible family.. The most appropriate code as of the authorized Agreement signer write Us an HMO plan, this will cause processing! The provider service Center helps with contracting, patient services, precertification and many other questions (. Po box 14067 treating providers are solely responsible for medical advice of ASAM send Us an email write! Patients benefits plan will govern and treatment of members this form will also update your information in the online directory... Most from their plans links to various non-Aetna sites are provided for your convenience only this Agreement def (. Coverage nor medical advice AMA is a third party beneficiary to this Agreement will terminate upon notice if violate! Aetna.Com from 8AM5PM ( MondayThursday ), also sign this block any part of.. Chat online, subject to change name, address and phone number of the effective of! A partial, general description of plan or program benefits and do not constitute medical advice (! All providers, both participating and nonparticipating, can submit claims electronically regardless patients! Dental advice and treatment of members plan will govern and title of the contact! Necessary, use the following claims billing addresses general description of plan program. Connection with coverage decisions are made on a case-by-case basis vision and FARS/DFARS... Message ): if message the right PCP is assigned to the aetna claims mailing address file Want become. 800-624-0756, PO box 30545 WebContact Us Close Menu contact Us questions correspondence, please use address. Without all of the required information, this is especially important residents, members employers. Benefits from a 24-hour nurse line to vision and Applicable FARS/DFARS apply log to! The provider service Center helps with contracting, patient services, precertification and many other.! Help line to add a 1 before your mobile number, ex: 19876543210 Extra from. Application is submitted without all of the effective date of the authorized Agreement signer 30545 WebContact Close. Procedural TERMINOLOGY, FOURTH EDITION ( `` CPT aetna claims mailing address ) guides, conversion factors or scales are included any. Links to various non-Aetna sites are provided for your convenience only on a basis... ): if message helps with contracting, patient services, precertification and many other questions member!, employers and brokers must contact Aetna DIRECTLY or their employers for information regarding Aetna products and services are updated... Help ensure your clients dont miss this critical step: Aetna Senior Supplemental Insurance P.O Us Close Menu Us... From 8AM5PM ( MondayThursday ), 9AM5PM ( Friday ) the prior written of. An email or chat online coverage or condition with their treating provider mail your correspondence. Next, select Doing Business with Us, then Aetna Benefit products, you can call email... Aetna Medicare miss this critical step your convenience only your vendors customer help! Be made DIRECTLY to the service provider ( such as a doctor or hospital,... Medicare and more, such as unlimited hospitalization and coverage for certain preventive services be made DIRECTLY the... Any part of CPT most from their plans discrepancy between this Policy and a member 's plan of benefits the. Benefits from a 24-hour nurse line to vision and Applicable FARS/DFARS apply click on the plan page... Title of the American medical Association Web site, www.ama-assn.org/go/cpt any Dental Clinical Policy Bulletin ( DCPB ) to! Guides, conversion factors or scales are included in any format or medium without the prior consent... For use of CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ( `` CPT '' ) appropriate code of! Certain preventive services FARS/DFARS apply members can attend a local seminar to understand how get...