Looking for a local dentist? 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. 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. The member's benefit plan determines coverage. The information you will be accessing is provided by another organization or vendor. To reduce the In case of a conflict between your plan documents and this information, the plan documents will govern. All Rights Reserved. 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. The AMA is a third party beneficiary to this Agreement. Or they can help you find a provider. 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 provider information contained on this website is subject to change. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If you do not intend to leave our site, close this message. 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. Please log in to your secure account to get what you need. Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Aetna Better Health of Maryland Medicaid Dental Provider Search - Avesis Visit the secure website, available through www.aetna.com, for more information. Need a new dental office home? The ABA Medical Necessity Guidedoes not constitute medical advice. Find a Dentist. 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. Applicable FARS/DFARS apply. Links to various non-Aetna sites are provided for your convenience only. 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). Medicaid your for low-income and working humans or families, their . Treating providers are solely responsible for medical advice and treatment of members. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. You are now being directed to CVS Caremark site. 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. Please confirm with the provider when you call them. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. Enter a zip code to search for dental care professionals in your area. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Please be sure to add a 1 before your mobile number, ex: 19876543210. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. 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. 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. Aetna Dentists Near Me. This search will use the five-tier subtype. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Aetna Better Health of Maryland Dental Provider Search - Avesis Do you want to continue? Others have four tiers, three tiers or two tiers. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Participating Providers: To determine if prior authorization (PA) is required, enter Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. 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). This search will use the five-tier subtype. Working with providers, our advanced care management techniques help increase quality, improve efficiency . Provider Directory Aetna Better Health of Pennsylvania. 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. ProPAT CPT Code Lookup : Aetna Better Health Pharmacy prior auth phone number: 1-855-221-5656. 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. Street Address: . Aetna Better Health Dental Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. You are now being directed to the CVS Health site. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. The information you will be accessing is provided by another organization or vendor. 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. Youd likely go to an oral surgeon if you have an impacted wisdom tooth or need another type of other complicated extraction. Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. Click here to request an office transfer. You are now being directed to the CVS Health site. 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. Unrivaled access to care in 200+ countries and territories around the world. It is only a partial, general description of plan or program benefits and does not constitute a contract. You will receive the discount off the providers usual and customary fees when you pay. Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. Treating providers are solely responsible for medical advice and treatment of members. For more details see our Privacy Policy. You can all Member Services at 1-866-638-1232, TTY PA Relay 7-1-1 , TTY 711, for help finding a provider. 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 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. The member's benefit plan determines coverage. Stay up-to-date with todays latest health care trends. General Dentists: provide all the services you need to maintain healthy teeth and gums. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 2/22). Be sure to check your email for periodic updates. DocFind, Aetna's online participating provider directory, allows you to locate physicians and other health care providers such as dentists, optometrists, hospitals and pharmacies. Prior Authorization may be required. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. Health benefits and health insurance plans contain exclusions and limitations. Please be sure to add a 1 before your mobile number, ex: 19876543210. Join our team. If you are looking for a specific provider and cannot find them online, need more information,help, or would like a printed copy of the provider directory mailed to you,callus at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . Health. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Learn about Aetna Smart Compare. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. Please review the plan benefit coverage documentation under the link below.