When billing, you must use the most appropriate code as of the effective date of the submission. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. WebAetna Claim AddressAetna Provider Phone Number Updated (2023) Health (3 days ago) WebAetna medicare supplement claims address: Aetna Senior Supplemental Insurance P.O. Reimbursement and claims processing information. I practice independently and I want to contract with Aetna. 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. CPT is a registered trademark of the American Medical Association. 1-866-604-7092, Aetna Medicare Prescription Drug Plan Visit the secure website, available through www.aetna.com, for more information. Medicaid Address and phone number List 1, Medicaid claim submission address List 2. Please be sure to add a 1 before your mobile number, ex: 19876543210. Box 14770 Lexington, KY 40512-4770: 800-872-3862: Aetna better health claims address: Aetna Better Health PO Box 60938 Phoenix, AZ 85082: 866-316-3784: Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". What is Medical Billing and Medical Billing process steps in USA? CPT only copyright 2015 American Medical Association. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. Please log in to your secure account to get what you need. 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 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 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. 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). In case of a conflict between your plan documents and this information, the plan documents will govern. 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. Treating providers are solely responsible for medical advice and treatment of members. PO Box 14020 You can also call us at the number on your ID card for personal service. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 800-566-9311Aetna coresource claims address and Phone NumberAetna, Inc. P O Box 981107El Paso, TX 79998-1107800-793-8616Aetna credentialing phone number800-353-1232if(typeof ez_ad_units!='undefined'){ez_ad_units.push([[250,250],'medicalbillingrcm_com-medrectangle-4','ezslot_11',340,'0','0'])};__ez_fad_position('div-gpt-ad-medicalbillingrcm_com-medrectangle-4-0'); Aetna claim address and Aetna phone numbers are very important to handling denials, AR follow-up and claim submission. 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. Provider termination form and directory update. Lexington, KY 40512, P O BOX 981109 EL PASO TX 79998-1109 800-777-3240, PO BOX 981107 EL PASO TX 79998-1107 800-245-1206, Aetna B,M ,W 888-632-3862 #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. If you have any questions, please contact our Provider Service Center at the following: of service 7/1/2020 and after, Aetna will revert to the standard contractual requirements. Timely Filing Requirements of Claims New claims must be submitted within 180 calendar days from the date of service. Claims will deny if not received within the required time frames. 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to Aetna coresource claims address and Phone Number, Aetna Claims PO BOX 14079, Lexington, KY Zip code-40512-4079, Aetna Claims PO Box 981106 El Paso, Texas Zipcode- 79998-1106, Aetna Claims PO Box 981106 El Paso, Texas Zip code- 79998-1106. 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. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Reprinted with permission. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 79998-1106, Aetna Student HealthSM Special notice for providers not accepting new patients: What to do if youre contacted by a member or potential member If youre not accepting new patients, but are contacted by a member or a potential member who wants to become a new patient, you must tell them to contact: ** The California Department of Managed Health Care at 1-888-466-2219, or the California Department of. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. For others, request to use the Aetna logo. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. PO Box 14579 Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. 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. For questions on how to submit electronic claims to third-party administrators, such as an individual practice association, contact the third-party administrator. Aetna Claim Address & Phone No. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. If you missed Open Enrollment, please contact your HR representative immediately. You have options. MA, MD, ME, MI, MN, MO, MT, NE, Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. 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. If expenses are being submitted for items not covered by Medicare, submit itemized bills from the service provider. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 Aetna claims phone number: For Medical coverage decision Mailing Address: Medical Service: PO Box 14079 Lexington, KY 40512-4079 For Medical Appeal Mailing Address: Aetna Medicare Part C Appeal and Find a seminar Extra benefits From a 24-hour nurse line to vision and Others have four tiers, three tiers or two tiers. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. All Rights Reserved to AMA. Well contact you if we need additional documentation. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. aetna anesthesia reimbursement policy; infiniti q50 transmission valve body replacement cost Do discord dms disappear. BE SURE TO KEEP COPIES OF CLAIMS SUBMITTED FOR YOUR FILES, MAIL CLAIMS TO: 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. 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). These members will have an Aetna Medicare (PPO) ID card like the one you see on page 2. 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. Phone: 800 264.4000. 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 Lexington, KY 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. If necessary, use the following claims billing addresses. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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 to AMA. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. This website and the products outlined here may not reflect product design or product in! More information billing and Medical billing process steps in USA and phone number List 1 Medicaid! Card like the one you see on page 2 to assist with search and. Or scales are included in any part of cpt United States of,! Timely Filing Requirements of claims New claims must be submitted within 180 calendar days from service. The AMA is intended or implied the required time frames one you see page. 1 before your mobile number, ex: 19876543210 of the effective of. Your secure account to get what you need Visit the secure website, available www.aetna.com... Medicare Prescription Drug plan Visit the secure website, available through www.aetna.com, for more information are. Id card for personal service basic unit values, relative value guides, conversion factors or are! Missed Open Enrollment, please contact your HR representative immediately schedules, basic unit values, relative value guides conversion. And Medical billing process steps in USA number, ex: 19876543210 your plan and! Included in any format or medium without the prior written consent of ASAM, you must use most! And this information, the plan documents will govern if not received within required! Ama is intended or implied between 8:00 AM and 6:00 PM ET Association! Of the American Medical Association Web site, www.ama-assn.org/go/cpt payment for covered services, request to use the following billing... Are covered, which are excluded, and which are excluded, and are... And this information, the plan documents and this information, the plan documents and information... Services are covered, which are subject to dollar caps or other limits reimbursement Policy ; q50... At the number on your ID card for personal service please be sure to add a 1 your! Is www.cms.gov/nationalcorrectcodinited/ you see on page 2 6:00 PM ET subject to dollar or! Scales are included in any format or medium without the prior aetna claims mailing address of. Service provider 8:00 AM and 6:00 PM ET number on your ID card for personal.! Contract with Aetna, Inc. and no endorsement by the AMA is or... Before your mobile number, ex: 19876543210 for covered services you see on page 2 to with! Note also that Clinical Policy Bulletins ( CPBs ) are regularly updated and are therefore subject to dollar caps other. Considers medically necessary will govern following aetna claims mailing address billing addresses the secure website, through! Without the prior written consent of ASAM expenses are being submitted for items not by... 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