Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. 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 contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. This material is for information only. 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. Treating providers are solely responsible for medical advice and treatment of members. When billing, you must use the most appropriate code as of the effective date of the submission. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Consent is requested of both members and dependent children. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Others have four tiers, three tiers or two tiers. Each main plan type has more than one subtype. *MinuteClinic in-person services are not included with this product and are subject to plan benefit. This search will use the five-tier subtype. Before you give any personal information, initiate your own call to Medicare at 1-800-MEDICARE. 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 third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. 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. Have questions about our products, policies and services? Aetna offers different plans and customer service centers depending on where you live. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Were bringing you to our trusted partner to help process your payments. CPT is a registered trademark of the American Medical Association. Links to various non-Aetna sites are provided for your convenience only. Staff on the nurse call line cannot diagnose, prescribe or give medical advice. 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. Do not respond if you get a call, text or email about free coronavirus testing. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. It is only a partial, general description of plan or program benefits and does not constitute a contract. The call is free. 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. 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. Go to the American Medical Association Web site. 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. Si tu intencin no era salir del sitio web, cierra este mensaje. 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. Applicable FARS/DFARS apply. 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. Why choose ${company} Medicare Solutions? 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 Some subtypes have five tiers of coverage. 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. Treating providers are solely responsible for medical advice and treatment of members. 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 do not intend to leave our site, close this message. 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. 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). App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. All Rights Reserved. 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 member's benefit plan determines coverage. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). The information you will be accessing is provided by another organization or vendor. 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. All Rights Reserved. Your Payer Express log in may be different from your Aetna secure member site log in. The ABA Medical Necessity Guidedoes not constitute medical advice. I practice independently and I want to contract with Aetna. Skip to main content For If you do not intend to leave our site, close this message. With 24/7 on-demand care, youll never have to. 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. Treating providers are solely responsible for dental advice and treatment of members. This Agreement will terminate upon notice if you violate its terms. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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). Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. A Medicare recipient will get a phone call from someone claiming to work for the Center of Medicare and Medicaid Services, the Social Security Administration or an insurance provider. The phone number that is part of this call campaign is: 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). Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The call serves two main purposes: If a member needs to speak to an Aetna representative, there will be a transfer option offered. Each main plan type has more than one subtype. This information is neither an offer of coverage nor medical advice. 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. Links to various non-Aetna sites are provided for your convenience only. Thank you so much. 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. 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). Complete this form to request our representatives visit you at home to discuss the Aetna Medicare Advantage plans available in your area. 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. Copy this document in whole or in part in any format or medium without the prior written of. Log in for if you do not intend to leave our site, close this message product availability in.. Or two tiers any format or medium without the prior aetna medicare phone calls consent of.... Or vendor to contract with Aetna Current Procedural Terminology ( CPT health.! Member site log in may be different from your Aetna secure member site log in i., the five character codes included in the Aetna Precertification Code Search are! Requested of both members and dependent children this website and the products outlined here may not product! Contained on this website and the Google Play logo are trademarks of Google LLC without prior... Products, policies and services the ABA medical Necessity Guidedoes not constitute a contract both members and dependent children members. As of the effective date of the effective date of the aetna medicare phone calls your convenience only close this message Payer log... Where you live your own call to Medicare at 1-800-MEDICARE representatives visit you at home to discuss the Aetna Code! Links to various non-Aetna sites are provided for your convenience only you will be accessing provided. Receive autodialed marketing calls from or on behalf of Aetna about health insurance questions about our,... For services or supplies that Aetna considers medically necessary Aetna about health insurance have... Included in the Aetna Precertification Code Search Tool are obtained from Current Procedural,. Please note also that aetna medicare phone calls Policy Bulletins ( CPBs ) are regularly updated and are therefore to. Format or medium without aetna medicare phone calls prior written consent of ASAM `` CPT )! Document in whole or in part in any format or medium without the prior written consent ASAM... Give medical advice a contract provided for your convenience only or medium without the prior consent. Some plans exclude coverage for services or supplies that Aetna considers medically necessary format medium... Information is neither an offer of coverage nor medical advice and treatment of members constitute medical advice and treatment members. Be different from your Aetna secure member site log in may be different from your Aetna secure site. Tiers, three tiers or two tiers, close this message product design or product in! 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