Dental Providers: Register now for AetnaDental.com Medical Providers: Register for Aetna's Provider portal on Availity: ALL inpatient confinements require PA and usually ALL services provided . Links to various non-Aetna sites are provided for your convenience only. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan 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 American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. Each main plan type has more than one subtype. 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. Your plan may only provide benefits if you obtain a referral from your General Dentist prior to receiving treatment from a Specialist. 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. Go to the American Medical Association Web site. 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. Or they can help you find a provider. . 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. Endodontists: help heal infections of the soft tissue inside the tooth and are typically the dental specialist youd see if you need a root canal treatment. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. If you have questions, visit our contact us page. 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). Pharmacy, dental or vision providers? Click here to find an in-network pharmacy provider thats close to you. All Rights Reserved. Health benefits and health insurance plans contain exclusions and limitations. 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. Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. Health benefits and health insurance plans contain exclusions and limitations. 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. Please review the plan benefit coverage documentation under the link below. Treating providers are solely responsible for medical advice and treatment of members. The information you will be accessing is provided by another organization or vendor. ALL inpatient confinements require PA and usually ALL services provided by non-participating providers require PA. PA requirement results are valid as of todays date only. 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. INVALID - CPT or HCPCS code entered was invalid, not found. Links to various non-Aetna sites are provided for your convenience only. Links to various non-Aetna sites are provided for your convenience only. The member's benefit plan determines coverage. Your Plan: Your Plan: Enter a zip code to search for dental care professionals in your area. We update our provider directory nightly.You can get a copy of the provider directory by mail. 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. You are now being directed to the CVS Health site. 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. 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). In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Filter Type: All Symptom Treatment Nutrition Dental Services Aetna Medicaid New Jersey . 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. 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 to or related to any use, non-use, or interpretation of information contained or not contained in this product. The AMA is a third party beneficiary to this Agreement. Treating providers are solely responsible for dental advice and treatment of members. We're sorry but Provider Locator doesn't work properly without JavaScript enabled. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. Let Customer Service know the providers you called. To reduce the You can also get the materials you need in a different language or format. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Provider Directory. Medicaid. Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Skip to main content . CPT is a registered trademark of the American Medical Association. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Aetna Inc. and itsaffiliated 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 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). You can further filter the search results by adding a specific dentist . If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Thanks! This information is neither an offer of coverage nor medical advice. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Enter Location Details Zip Code: OR. 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. Pharmacy prior auth phone number: 1-855-221-5656. All provider information contained on this website is subject to change. Plan highlights. 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. you can call Aetna Better Health of Louisiana Member Services at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. Your benefits plan determines coverage. Request an Office Transfer. If English is not your preferred language and you need help communicating in your preferred language, you may call 888-703-6999 to ask what language services are available to you. Exception Detail, Svc Partner Detail - When the. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . and you keep saving there is no maximum annual spending limit! By clicking on I accept, I acknowledge and accept that: Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Learn about Aetna Smart Compare. ", Provider/facility name OR specialty is required to continue. Directory of Dentists Treating Members with Intellectual . Links to various non-Aetna sites are provided for your convenience only. Learn about your health plan or find coverage for you and your family. 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 Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Our find a dentist tool includes a brief survey to help us improve this service. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Unlisted, unspecified and nonspecific codes should be avoided. CPT is a registered trademark of the American Medical Association. #2020 . Want to help transform health care? System (HCPCS) codes or a CPT group and select SEARCH. What's covered? Links to various non-Aetna sites are provided for your convenience only. 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). They also provide cosmetic services such as overlays and whitening treatments. Aetnamedicare.blob.core.windows.net. 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. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. 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. Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit, relative values or related listings are included in CPT. Links to various non-Aetna sites are provided for your convenience only. 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. Applicable FARS/DFARS apply. It is only a partial, general description of plan or program benefits and does not constitute a contract. Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. 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). Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. Directory of Dentists Treating Members with Intellectual Disabilities Adult. 2023 DentalPlans.com, Inc. All Rights Reserved. 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. 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. All rights reserved | Email: [emailprotected], North country health care university flagstaff. Links to various non-Aetna sites are provided for your convenience only. You also can look for more than 25 other types of health care providers, including pharmacies, marriage counselors, urgent care centers, acupuncturists, drug and alcohol counselors, hospice care providers, dialysis centers, vision care providers, flu . Due to the impact of the COVID-19 pandemic, many provider offices may need to adjust their office hours or redirect patients to others offices. Some subtypes have five tiers of coverage. LIBERTY makes certain language assistance services available to you at no cost. If you wish to make a standing request to receive all materials in a language other than English or in an alternate format, you can call Aetna Better Health ofLouisiana Member Services at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. The DSNP network is in limited counties. Log in to find doctors, dentists, hospitals and other providers that accept your plan. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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-network coverage only (except emergency . Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Individual dental plan. Prior Authorization may be required. 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. Provider/Facility Name OR Specialty is required to continue, Please enter first and last name of Provider, or the name of the facility. 1. Exploration our provider manuals for find resources concerning Aetna policy guidelines that explain how to work with us. There is no obligation to enroll. 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. Request an Office Transfer. NON-COV - CPT or HCPCS code entered is not a covered benefit by health plan. The ABA Medical Necessity Guidedoes not constitute medical advice. 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 be sure to add a 1 before your mobile number, ex: 19876543210. Unlisted, unspecified and nonspecific codes should be avoided. 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. Please enable it to continue. You start saving within 72 hours of joining a plan (no long waits before you qualify for discounted care!) New and revised codes are added to the CPBs as they are updated. CPT only Copyright 2022 American Medical Association. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Provider site; Please america; Search. 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. 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. 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. You also can look for more than 25 other types of health care providers, including pharmacies, marriage counselors, urgent care centers, acupuncturists, drug and alcohol counselors, hospice care providers, dialysis centers, vision care providers, flu shot providers and physical therapists. Family planning, Emergent and Urgent Care services do not require PA. To see if your doctor is in our network, click a plan link below. Enter your location by address, city or zip code. If you are looking for a specific provider and cannot find them online, need more information,help, or would like a printed copy of the provider directory mailed to you,callus at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week.
aetna better health dental provider search
Login
0 Comentarios