on October 21, 2023
We're sorry but Provider Locator doesn't work properly without JavaScript enabled. Others have four tiers, three tiers or two tiers. Find a Doctor, Dentist or Hospital | Aetna For children and other Medicaid members, dental providers are available through MCNA. 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. Dental Provider Login | Aetna #2020 . Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. 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. 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. We update our provider directory nightly. 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. Enter a zip code to search for dental care professionals in your area. CPT only copyright 2015 American Medical Association. HMO Plan*; Open Access Plan; QCHP/CDHP Plan; For step-by-step instructions, click on a plan below. Click here to find an in-network vision provider thats close to you. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. 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. Visit the secure website, available through www.aetna.com, for more information. The term prior authorization (PA) means the utilization review process determines whether the requested service, procedure, prescription drug or medical device meets the companys clinical criteria for coverage. AetnaDentalOffers.com is brought to you by DentalPlans.com. 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. Applicable FARS/DFARS apply. Of course you can use our directories to find doctors and hospitals that take your insurance. Go to the American Medical Association Web site. . Please check before scheduling an appointment to make sure the provider is participating in the program. Links to various non-Aetna sites are provided for your convenience only. Unlisted, unspecified and nonspecific codes should be avoided. You can all Member Services at 1-866-638-1232, TTY PA Relay 7-1-1 , TTY 711, for help finding a provider. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Aetna Better Health Dental Provider ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. 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. Links to various non-Aetna sites are provided for your convenience only. 2020 Avsis Incorporated. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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 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. Others have four tiers, three tiers or two tiers. 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. PA requirements are both Yes and No, as specified on the PA List. 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. To check that your provider participates, visit our website or call us. Visit the secure website, available through www.aetna.com, for more information. 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. VisitPharmacy Provider Search to view all your pharmacy providers. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. 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. 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. Participating Providers: To determine if prior authorization (PA) is required, enter 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. Aetna Better Health of Illinois is not responsible or liable for non-Aetna Better Health content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. 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. The member's benefit plan determines coverage. For language services, please call the number on your member ID card and request an operator. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Find a Dentist. 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. 1. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. This search will use the five-tier subtype. 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?. Are you looking for free COVID-19 testing providers? 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. Youll find these doctors with the label Quality Care, Effective , https://www.aetna.com/individuals-families/find-a-doctor.html, North country health care university flagstaff, Jps health network schedule appointments, Health care information system examples, 2021 health-improve.org. Provider Directory. Do you want to continue? We update our provider directory nightly.You can get a copy of the provider directory by mail. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part 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. All Rights Reserved. Please log in to your secure account to get what you need. 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). Members must choose a PCP* to guide their treatment and coordinate all specialist care which all takes place in a quality network to keep costs in check. Applicable FARS/DFARS apply. 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. If your health benefit plan offers the Aetna Signature Administrators (ASA) PPO Network, use its online directory to search from approximately 1.4 million Aetna in-network providers and more than 6,000 hospitals nationwide. Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. Search By NPI or PIN : DocFind - aetna.com Let Customer Service know the providers you called. The DSNP network is in limited counties. Each main plan type has more than one subtype. Aetna Better Health is not responsible or liable for non-Aetna Better Health content accuracy or privacy practices of linked sites or for products or services described on these . 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. Prior Authorization may be required. Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit, relative values or related listings are included in CPT. Aetna Better Health - LIBERTY Dental Plan Tools and resources that create a more personalized and convenient . Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. All Rights Reserved. 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. *Search by : Provider ID (PIN) NPI. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Louisiana, All Rights Reserved. By submitting your information you are agreeing to receive communications from Aetna Dental Offers.
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