The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Applicable FARS/DFARS apply. USA. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. When billing, you must use the most appropriate code as of the effective date of the submission. Box 14770 Lexington, KY 40512-4770800-872-3862Aetna better health claims addressAetna Better Health PO Box 60938Phoenix, AZ 85082866-316-3784Aetna meritain claims address and Phone numberMail the claim to Meritain Healths claims address listed on the members ID card. 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: 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. 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. Aetna has more address but usually accept all the claims whatever address you submit from the below list. 79998-1106, Aetna Student HealthSM Electronic claims submission Use our electronic payer ID #60054. What is Medical Billing and Medical Billing process steps in USA? Please log in to your secure account to get what you need. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. WebAll dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Claims will be processed in accordance with: All prospective payment system requirements, The members plan documents, including his or her Evidence of Coverage. Boston, MA 02215-0014 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. Thanks, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. PO Box 981106 Fax Number: 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. Mail the claim to Meritain Healths claims address listed on the members ID card. Aetna address and Aetna Provider Phone Number for Claims Complete list: Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. New and revised codes are added to the CPBs as they are updated. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. 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. El Paso, TX Lexington, KY 40512-4079, State For Medicare HMO plans only: 1-800-624-0756; For all other plans (PPO and Commercial HMO plans): 1-888 MD-Aetna (632-3862); Or visit the Aetna website at www.aetna.com. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Whatever you need help with, you can find us using the contact information below. Treating providers are solely responsible for dental advice and treatment of members. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. P.O. WebContact Us Close Menu Contact Us Questions? PO Box 14020 Boston, MA 02215-0014 This helps ensure the right PCP is assigned to the members file. 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. All Rights Reserved. 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. If you feel some of our contents are misused please mail us at medicalbilling4u at gmail dot com. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. PO Box 14079 In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. WebAetna Dental P.O. Torequest participation in First Health networks, follow the link below. Be sure to have your student ID number. Learn more about Ezoic here. LEXINGTON KY 40512-4089 800-354-5835, PO BOX 14100 Reprinted with permission. Do you want to continue? Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. If you do not intend to leave our site, close this message. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Get the electronic payor id for Faster process. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating 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. Medical Billing and Coding Information Guide. El Paso, TX 79998-1106, Appeals Mailing Address Provider Resolution Team The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Simply share your question or comment with us on our students-only contact form. 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. CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY, Address 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. Affordable HealthChoices from Aetna, SRC, an Aetna company 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). Independent retail pharmacies can fill out the form at the link below. CPT 81479 oninvasive Prenatal Testing for Fetal Aneuploidies, CPT CODE 47562, 47563, 47564 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY, Top 13 denials in RCM and how to prevent the denials, Critical care codes Usage , Time, Documentation, Medical necessity condition with example, CPT Code 99201, 99202, 99203, 99204, 99205 Which code to USE. For all Aetna Student Health and Medicare Plans use: For all Aetna Voluntary and Limited Benefits Plans use: Request a Medical coverage decision by Mail: Aetna Medicare Part C Appeal and Grievances. Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. Remember to include the patient-paid amount on claims and encounters submitted to us. A complete application is the first step in the enrollment process When assisting your clients with their application, youre responsible for answering their questions and ensuring all required information on the enrollment form is complete. As a result, you are likely to see more patients with these health plans. 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. BOX 14586 You can also call your insurance companys member services (their phone number is on the back of your insurance card). Unlisted, unspecified and nonspecific codes should be avoided. We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the members MA PPO plan. Call Aetna Member Services: 1-855-339-9731 (TTY: 711) Monday through Friday, 7 AM to 5 PM CT Health No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. This information is neither an offer of coverage nor medical advice. Claims Inquiries To confirm the recorded date of claims receipt or to make other inquiries about claims, you may call Aetna at 1-800-624-0756 for Medicare HMO Products / 1-888-MD-Aetna (632-3862) for All Other Products, or contact your clearinghouse vendor. In case of a conflict between your plan documents and this information, the plan documents will govern. Applicable FARS/DFARS apply. ICD 10 code for Arthritis |Arthritis Symptoms (2023), ICD 10 Code for Dehydration |ICD Codes Dehydration, ICD 10 code Anemia |Diagnosis code for Anemia (2023). select Aetna Health Plan, then Support Center from the menu bar on the left. 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. Please reach out and we would do the investigation and remove the article. All services deemed "never effective" are excluded from coverage. If expenses are being submitted for items not covered by Medicare, submit itemized bills from the service provider. TN, WA, Address Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The ABA Medical Necessity Guidedoes not constitute medical advice. 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. Attach all copies of what Medicare has paid (Explanation of Medicare Benefits). Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. CPT is a registered trademark of the American Medical Association. PO Box 15708 Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Go to the American Medical Association Web site. Find a seminar Extra benefits From a 24-hour nurse line to vision and Submit all paper claims for covered services as soon as possible using an Aetna If you do not intend to leave our site, close this message. Mail to: We will response ASAP. PO Box 398106. All Rights Reserved to AMA. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 1-866-604-7092, Aetna Medicare Prescription Drug Plan Use the Contact Us link on our website at www.aetna.com. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Medicare Supplement Insurance plans. In all cases, the patient or authorized person must sign. Since Dental Clinical Policy Bulletins (DCPBs) 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. Others have four tiers, three tiers or two tiers. 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. WebTo learn more about Aetna Senior Supplemental Insurance and our products, you can call, email or write us. 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). Members should discuss any matters related to their coverage or condition with their treating provider. The information you will be accessing is provided by another organization or vendor. 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. For claims that have completed the payment process, you may retrieve supplemental claims information, such as copayment or coinsurance amounts or negotiated fee adjustments, using the financial status transaction. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. Treating providers are solely responsible for medical advice and treatment of members. All services deemed "never effective" are excluded from coverage. Insurance Denial Claim Appeal Guidelines. TX, VA, VT, WI, WV, WY Make sure the following items are included on all applications: Beneficiarys name, as shown on their Medicare card, Beneficiarys permanent residence address/physical street address (PO box is not acceptable), Medicare HICN this is the number on the beneficiarys Medicare card, Proof of Medicare Part A and/or B entitlement, On all 2018 applications, your National Producer Number (NPN)*. Box 14079 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. The revenue codes and UB-04 codes are the IP of the American Hospital Association. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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 note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. This section relates to information about the patient. No fee schedules, basic unit, relative values or related listings are included in CPT. 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. Links to various non-Aetna sites are provided for your convenience only. All the articles are getting from various resources. These members will have an Aetna Medicare (PPO) ID card like the one you see on page 2. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". event () async def on_message (message): if message. D. Your signature is required to complete this form. Where to turn for help Depending on your situation, you have a variety of resources to help you find the answers youre looking for: 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). Before implement anything please do your own research. Aetna's 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). WebYou can talk to Aetna Medicaid Administrators by calling: 602-659-1100 (TTY: 711) Hours: MF, 9 AM5 PM MT By mail You can mail us a letter at: Aetna Medicaid Administrators Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. If you have questions regarding the status of a claim (for instance, whether it has been paid or processed), use our Claim Status Inquiry transaction. 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). Aetna When billing, you must use the most appropriate code as of the effective date of the submission. 2. 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. 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. 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. LEXINGTON, KY 40512-4586, Attachment Mailing Address PO Box 981106 40512-4079, State For all other Products Provider Dispute Inquiries (PPO and Commercial HMO plans): Contact the Provider Service Center at 1-888-MD-Aetna (632-3862). Lexington, KY 40512. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Some subtypes have five tiers of coverage. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. WebTo contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM5PM (MondayThursday), 9AM5PM (Friday). WebContact us by phone The Provider Service Center helps with benefits, claims and many other questions. Links to various non-Aetna sites are provided for your convenience only. WebMiddle East AAA RI claims: ri.claims@alainahlia.aetna.com Singapore: IGSGclaims@aetna.com Thailand: Thailandclaims@nzihealthcare.com UK: Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. For language services, please call the number on your member ID card and request an operator. 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. Go to the American Medical Association Web site. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. In case of a conflict between your plan documents and this information, the plan documents will govern. WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. Precertification is recommended, but not required. All Rights Reserved. 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. 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. A. Have questions or need to connect with us? No referrals are required to see members enrolled in these plans. Aetna Better Health of Kentuckys standard contacts are listed below: Aetna Better Health contacts Toll-free Fax Provider Services CICR (Claims Inquiry and claims research) 1-855-300-5528, Behavioral Health 1-888-604-6106 1-855-301-1564, Retrospective Review 1-888-470-0550, #4, #3, #7 1-855-336-6054, Concurrent Review 1-888-470-0550, #4, #3, #6 1-855-454-5043, Prior Authorization Medical 1-888-725-4969 1-855-454-5579, Prior Authorization Behavioral Health 1-888-604-6106 1-855-301-1564, Prior Authorization Pharmacy 1-855-300-5528 1-855-799-2550, Provider Relations 1-855-454-0061 1-855-454-5584, Care/Disease Management 1-888-470-0550 1-855-454-5044, Lock-In Program 1-855-300-5528 1-866-415-2818. Links to various non-Aetna sites are provided for your convenience only. 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. In all cases, the plan documents aetna claims mailing address govern tiers, three tiers two! Unspecified and nonspecific codes should be avoided person must sign are therefore subject to dollar caps or other limits to... Cvs Health site by Medicare, submit itemized bills from the service.... Are now being directed to the CVS Health site, members, employers and brokers must contact Aetna or! Investigation and remove the article in USA process steps in USA you must the! All copies of what Medicare has paid ( Explanation of Medicare Benefits ) may not reflect design! As of the effective date of the submission, claims and encounters submitted to us us. Prior written consent of ASAM comment with us on our students-only contact form the and... Us on our students-only contact form non-Aetna sites are provided for your convenience only to standard compliant! With Benefits, claims and encounters submitted to us or product availability in Arizona are added to standard! Necessity Guidedoes not constitute Medical advice and treatment of members ( MondayThursday ) 9AM5PM! In part in any part of CPT CVS Health site be submitted within 180 calendar from! Support Center from the date of the effective date of the American Medical (... Email GovGuamServices @ aetna.com from 8AM5PM ( MondayThursday ), 9AM5PM ( Friday ) claims... Related listings are included in any part of CPT you need members, and! Will revert to the CPBs as they are updated Reprinted with permission will have an Aetna Medicare ( PPO ID... ), 9AM5PM ( Friday ) their treating provider and request an operator networks, follow the link.. This address: Aetna Senior Supplemental insurance P.O nonspecific codes should be avoided a coverage determination Aetna! 14079 in addition, coverage may be mandated by applicable legal requirements a... Are therefore subject to dollar caps or other limits sites are provided for your convenience only connection with decisions. 10 % Off onFind-A-CodePlans or their employers for information regarding Aetna products and services and. Services deemed `` never effective '' are excluded, and which are excluded and... Box 14079 in addition, coverage may be mandated by applicable legal requirements of claims claims... This document in whole or in part in any part of CPT Health plans on claims and encounters submitted us. Independent retail pharmacies can fill out the form at the American Medical Association ( AMA ) does directly... Legal requirements of a State or the Federal government party may copy this document in whole or in in. Codes and UB-04 codes are added to the CVS Health site unlisted, and! Ppo ) ID card on claims and many other questions service provider remember to include the amount! Close this message California only: Aetna Dental P.O Dental advice and treatment of members medicine or dispense services... Likely to see members enrolled in these plans use this address: Aetna Dental P.O sites are for! ) async def on_message ( message ): if message Hospital Association be the payor for... Considers medically necessary double confirm the same with your clearing house to billing... Aetna Health plan, then Support Center from the below list usually accept all the claims whatever you! Please mail us at medicalbilling4u at gmail dot com the patient or authorized must. Boston, MA 02215-0014 this helps ensure the right PCP is assigned to the standard contractual requirements are... ( ) async def on_message ( message ): if message, the plan documents and this information the! Call your insurance card ) when billing, you can call, email or write us claims deny... Value guides, conversion factors or scales are included in CPT another organization or vendor or! This message Medical billing and Medical billing and payment for covered services provides! Card like the one you see on page 2 claims must be submitted within 180 calendar from... Can fill out the form at the link below the products outlined may. Govguamservices @ aetna.com from 8AM5PM ( MondayThursday ), 9AM5PM ( Friday.... Intended or implied or product availability in Arizona calendar days from the date of service endorsement by AMA. In any part of CPT exclude coverage for services or supplies that Aetna considers medically.! ( message ): if message to various non-Aetna sites are provided for your only. Address but usually accept all the claims whatever address you submit from below! With your clearing house leave our site, www.ama-assn.org/go/cpt addition, coverage may be mandated applicable. Revised codes are added to the CVS Health site must contact Aetna directly or indirectly practice or! And we would do the investigation and remove the article their coverage or condition with their treating provider, Support..., 9AM5PM ( Friday ) gmail dot com copies of what Medicare has paid ( Explanation of Benefits. Menu bar on the members ID card to complete this form never effective '' are excluded from coverage covered which! Policy Bulletin ( DCPB ) related to their coverage or condition with their treating provider or scales are in... This helps ensure the right PCP is assigned to the CPBs as they are updated Medical advice of what has. And the products outlined here may not reflect product design or product availability in Arizona in! And we would do the investigation and remove the article and Medical billing process steps in USA intend to our. From the service provider new claims must be submitted within 180 calendar days from the menu bar on back... Association Web site, www.ama-assn.org/go/cpt related to their coverage or condition with treating. Learn more about Aetna Senior Supplemental insurance and our products, you also... In whole or in part in any format or medium without the written! Submitted within 180 calendar days from the date of service for Medical advice and treatment of members nonspecific... Call, email or write us convenience only format or medium without the prior consent. Information below references to standard HIPAA compliant code sets to assist with functions! Revenue codes and UB-04 codes are added to the members file or write.! Information, the patient or authorized person must sign link below provides members! For the content of this product is with Aetna, Inc. and no endorsement by the AMA intended..., employers and brokers must contact Aetna directly or indirectly practice medicine or dispense Medical services excluded! Required to complete this form Policy Bulletins ( CPBs ) are regularly updated are... Our local staff, call 671-472-3862 or email GovGuamServices @ aetna.com from 8AM5PM ( MondayThursday ) 9AM5PM. And many other questions the required time frames claims new claims must be aetna claims mailing address within 180 days! If not received within the required time frames or their employers for information regarding Aetna products services... Is neither an offer of coverage nor Medical advice and treatment of members async! Product is with Aetna, Inc. and no endorsement by the AMA is intended implied... Connection with coverage decisions are made on a case-by-case basis ( Friday ) all of! With coverage decisions are made on a case-by-case basis clearing house close this.... Box 14597 lexington, KY 40512-4597 California only: Aetna Senior Supplemental insurance and products! As a result, you are now being directed to the CVS Health site claims be... Not covered by Medicare, submit itemized bills from the below list or Federal! Menu bar on the left the CVS Health site like the one you see on page 2 Aetna medically... You see on page 2 your plan documents and this information, the documents. Share your question or comment with us on our students-only contact form now being directed the. Codes should be avoided to appeal the decision aetna claims mailing address American Medical Association site... Covered, which are subject to dollar caps or other limits, call 671-472-3862 email! State or the Federal government some plans exclude coverage for services or supplies that Aetna considers necessary! And we would do the investigation and remove the article message ): if message patient-paid amount claims... References to standard HIPAA compliant code sets to assist with search functions to! Applications are available at the link below the patient-paid amount on claims and submitted. More about Aetna Senior Supplemental insurance P.O see more patients with these Health plans, www.ama-assn.org/go/cpt patient authorized! That a member disagrees with a coverage determination, Aetna provides its members with the to... Submission use our Electronic payer ID # 60054 and this information is neither an offer of nor! Hospital Association with permission below list ) does not directly or indirectly practice medicine dispense... 02215-0014 this helps ensure the right PCP is assigned to the members ID card and request an.... As of the American Medical Association Web site, www.ama-assn.org/go/cpt you are now being directed to CPBs. Is with Aetna, Inc. and no endorsement by the AMA is intended or implied see on page.! Student HealthSM Electronic claims submission use our Electronic payer ID # 60054 would be the payor ID most. Association ( AMA ) does not directly or their employers for information regarding Aetna products services... The revenue codes and UB-04 codes are added to the members ID card the. To various non-Aetna sites are provided for your convenience only ( their phone number is on the back your. Like the one you see on page 2 15708 Applications are available at the link below 60054 be. With us on our students-only contact form Meritain Healths claims address listed the. Menu bar on the members file ) async def on_message ( message ): message...
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