Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. 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). Thanks! Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. This Agreement will terminate upon notice if you violate its terms. If you have questions, visit our contact us page. Vision Provider Locator Links to various non-Aetna sites are provided for your convenience only. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. Aetna Inc. and its affiliated 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. 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. 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. 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. Health (9 days ago) WebProvider Search Find a Provider 1. A DSNP is a special type of Aetna Medicare Advantage Prescription Drug (MAPD) plan. 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. 1999- These directories of Louisianas network providers includes: Enter provider or facility name or select a specialty. You can email your search results or print them. From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. Geographic Search. If your patient has primary Medicare coverage outside of Aetna Better Health Premier Plan, please call the Medicare plan for benefits and authorization requirements. You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . Some subtypes have five tiers of coverage. Links to various non-Aetna sites are provided for your convenience only. 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. You can also get the materials you need in a different language or format. 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. Unlisted, unspecified and nonspecific codes should be avoided. Please confirm with the provider when you call them. Address, phone number, and practice changes. Health benefits and health insurance plans contain exclusions and limitations. Note not all plans and offers available in all markets. Links to various non-Aetna sites are provided for your convenience only. All Rights Reserved. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. #2020-93661 (exp. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Request an Office Transfer. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Medicaid your for low-income and working humans or families, their . Health (3 days ago) Webfor a provider. Some subtypes have five tiers of coverage. Find a Dentist. No fee schedules, basic unit, relative values or related listings are included in CPT. System (HCPCS) codes or a CPT group and select SEARCH. You are now being directed to the CVS Health site. 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. Do you want to continue? Go to the American Medical Association Web site. All services deemed "never effective" are excluded from coverage. 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. Links to various non-Aetna sites are provided for your convenience only. * Enter Provider ID : * Enter NPI : *Provider Type : Select a Provider Type Medical (Includes Behavioral Health) Dental Facilities. Helping you find the right doctor for you. This Agreement will terminate upon notice if you violate its terms. 2. Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. 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. New and revised codes are added to the CPBs as they are updated. 2023 LIBERTY Dental Plan, All Rights Reserved. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Oncology treatment plans must be submitted to NantHealth via their web portal, Eviti Connect, which will expedite clinical review of any chemotherapy, radiation therapy, or supportive medications that require prior-authorization. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Links to various non-Aetna sites are provided for your convenience only. Please enable it to continue. 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". The dental discounts are available through participating healthcare providers only. 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. You are now being directed to the CVS Health site. Request a medical application. If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health Provider Relations at 1-855-364-0974. For more details see our Privacy Policy. Aetna Dentists Near Me. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. AetnaDentalOffers.com is brought to you by DentalPlans.com. Please feel free tocontact us to provide any new information. Applicable FARS/DFARS apply. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. Members should discuss any matters related to their coverage or condition with their treating provider. 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. 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. Listing Websites about Aetna Better Health Dental Provider. Please consult with the respective plan detail page for additional plan terms. CMS requires providers to take the Model of Care training course (PDF). Please review the plan benefit coverage documentation under the link below. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. You can also get the materials you need in a different language or format. Aetna Better Health of Maryland Dental Provider Search. Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . Are you looking for free COVID-19 testing providers? The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. ProPAT CPT Code Lookup : Aetna Better Health of Kansas Were a health care company thats building a healthier world. Applicable FARS/DFARS apply. 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. Participating Providers: To determine if prior authorization (PA) is required, enter Plan highlights. Find a Doctor, Dentist or Hospital | Aetna Join our network, and together, we'll give patients access to the highest quality, safest and most effective health care. 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. Aetna Better Health Dental Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. HMO Plan*; Open Access Plan; QCHP/CDHP Plan; For step-by-step instructions, click on a plan below. Youd likely go to an oral surgeon if you have an impacted wisdom tooth or need another type of other complicated extraction. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. Directory of Dentists Treating Members with Intellectual . The online provider directory is updateddaily. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. You are now being directed to CVS Caremark site. Dental Provider Login | Aetna 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. You can all Member Services at 1-866-638-1232, TTY PA Relay 7-1-1 , TTY 711, for help finding a provider. Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. Or they can help you find a provider. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. You can get dental care when you join Aetna Better Health of West Virginia. Orthodontists: correct the position of misaligned teeth and jaws, typically this is done with braces although treatments using other dental devices (such as retainers) are also utilized. Learn about your health plan or find coverage for you and your family. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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 five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. New and revised codes are added to the CPBs as they are updated. 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. Future changes to CPT or Healthcare Common Procedure Coding System (HCPCS) codes that require PA will be communicated by Aetna Better Health Premier Plan in writing and on the homepage of Aetna Better Healths secure web portal. Note not all Aetna dental plans and offers available in all markets. 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. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . 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. Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination. The member's benefit plan determines coverage. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Treating providers are solely responsible for medical advice and treatment of members. New and revised codes are added to the CPBs as they are updated. 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. ", Provider/facility name OR specialty is required to continue. Aetna Inc. and its affiliated 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. If you do not intend to leave our site, close this message. 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 . 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. list of CPT or HCPCS codes to only those requiring PA, please check the box labelled Include only CPT or HCPCS codes where PA is required?. Please be sure to add a 1 before your mobile number, ex: 19876543210. SELECT A DIRECTORY. Click here to let us know so we can fix it. Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. We work with physicians to develop common platforms and goals, shifting the focus from episodes of care to making patient populations healthier. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". You can use the links below to find in-network providers and pharmacies nearyou. The member's benefit plan determines coverage. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. 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. Please be sure to add a 1 before your mobile number, ex: 19876543210. 2022 DSNP information - Aetna 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Find your plan listed below and click Find a Dentist. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Find a Doctor, Dentist or Hospital | Aetna Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Be sure to check your email for periodic updates. Unlisted, unspecified and nonspecific codes should be avoided. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Besides treating dental conditions, she educates her young patients on the importance of proper dental health and dispenses practical advice on maintaining dental hygiene. Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. In-network coverage only (except emergency . Aetna Medicaid collaborates with providers to deliver care that meets cost and quality goals. The AMA is a third party beneficiary to this Agreement. Find an Aetna Dentist in Your Area | Aetna Dentists Near Me Links to various non-Aetna sites are provided for your convenience only. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The member's benefit plan determines coverage. Enter your location by address, city or zip code. 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. 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.
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