aetna better health dental provider search

CPT only Copyright 2022 American Medical Association. Request a medical application. Were a health care company thats building a healthier world. 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. Providers may not balance bill members who do not have cost-share responsibility (including QMB-only). Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan The information you will be accessing is provided by another organization or vendor. Aetna Better Health. When billing, you must use the most appropriate code as of the effective date of the submission. 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). Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. The path to healthy starts here. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. You can further filter the search results by adding a specific dentists name and/or the type of dental specialist you wish to see. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Participating Providers: To determine if prior authorization (PA) is required, enter Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. Applicable FARS/DFARS apply. The five character codes included in the Aetna Medicaid PA Requirement Search Tool are obtained from Current Procedural Terminology (CPT), by the American Medical Association (AMA).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. This Agreement will terminate upon notice if you violate its terms. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. Or they can help you find a provider. Links to various non-Aetna sites are provided for your convenience only. You can also get the materials you need in a different language or format. Aetna Medicaid collaborates with providers to deliver care that meets cost and quality goals. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. . Copyright 2015 by the American Society of Addiction Medicine. Please enable it to continue. System (HCPCS) codes or a CPT group and select SEARCH. 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. Helping you find the right doctor for you. 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. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Street Address: City: State: County: Zip Code: Radius: . Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Did you find information that you think may need to be updated in our provider directories? Enter Location As a LIBERTY enrollee (including enrollees with disabilities), you have full and equal access to covered services as required under the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Want to help transform health care? Treating providers are solely responsible for medical advice and treatment of members. Click here to request an office transfer. Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Unlisted, unspecified and nonspecific codes should be avoided. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Do you want to continue? *Required Selections. You start saving within 72 hours of joining a plan (no long waits before you qualify for discounted care!) Working with providers, our advanced care management techniques help increase quality, improve efficiency . 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. What's covered? Disclaimer of Warranties and Liabilities. 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. For Use by Doctors and Facilities only. Learn more about our dental advantages. This Agreement will terminate upon notice if you violate its terms. logo Aethna Better Health of West Virginia. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. Unlisted, unspecified and nonspecific codes should be avoided. You start saving within 72 hours of joining a plan (no long waits before you , https://www.aetnadentaloffers.com/find-a-dentist, Health (1 days ago) WebAetna Smart Compare is a designation we give to doctors in our network who have proven time and again that they provide high-quality, effective care. 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. 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 Provider. To see if your doctor is in our network, click a plan link below. ", Provider/facility name OR specialty is required to continue. SELECT A DIRECTORY. New and revised codes are added to the CPBs as they are updated. Click here to let us know so we can fix it. To check that your provider participates, visit our website or call us. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. CPT only copyright 2015 American Medical Association. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. Primary care physicians, specialists, mental health providers and family planning providers, Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Clinics, Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. 1999- All services deemed "never effective" are excluded from coverage. Aetna Smart Compare is a designation we give to doctors in our network who have proven time and again that they provide high-quality, effective care. 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). To reduce the 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. Go to the American Medical Association Web site. Links to various non-Aetna sites are provided for your convenience only. INVALID - CPT or HCPCS code entered was invalid, not found. 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). You'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. Please contact Access2Care for benefit information by calling 1-866-252-5634 or visit www.Access2Care.net. Thanks! 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). In-network coverage only (except emergency . 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 Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. The member's benefit plan determines coverage. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. No fee schedules, basic unit, relative values or related listings are included in CPT. Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. The AMA is a third party beneficiary to this Agreement. 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. For enhanced adults benefit, visitDental Provider Searchto view your dental providers. 2023 LIBERTY Dental Plan, All Rights Reserved. A DSNP is a special type of Aetna Medicare Advantage Prescription Drug (MAPD) plan. Members should discuss any matters related to their coverage or condition with their treating provider. 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. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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 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. Select a Plan * Select a Plan: 2. 2. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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). Treating providers are solely responsible for dental advice and treatment of members. Request an Office Transfer. The information you will be accessing is provided by another organization or vendor. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). This list is updated nightly. These services include preventive care like cleanings and checkups, along with restorative services such as fillings, root canals, crowns and other treatments for broken or missing teeth. This search will use the five-tier subtype. This Agreement will terminate upon notice if you violate its terms. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Stay up-to-date with todays latest health care trends. Let Customer Service know the providers you called. 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. From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. Search results are not a guarantee of claim payment. 1. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Family planning, Emergent and Urgent Care services do not require PA. 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). 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. 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. Skip to main content . ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Please log in to your secure account to get what you need. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Check your participation status using the provider search tool.

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