aetna claims mailing address

Aetna When billing, you must use the most appropriate code as of the effective date of the submission. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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 Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. CPT is a registered trademark of the American Medical Association. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. New and revised codes are added to the CPBs as they are updated. Please fill in all fields. Aetna Medicare Grievance & Appeals All Rights Reserved. WebAetna Inc. 151 Farmington Avenue Hartford, CT 06156 USA Call us 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. 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. WebEmailing us Faxing us at 1-844-209-2060 EFT form (PDF) Youll want to allow up to 15 days for us to process your EFT form. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Be sure to have your student ID number. 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 matters related to their coverage or condition with their treating provider. Aetna Member Services Aetna Address for Member Services; Corporate Headquarters: 151 Farmington Avenue Hartford, CT 06156: Aetna addresses for While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. All the information are educational purpose only and we are not guarantee of accuracy of information. Hartford, CT 06156 Medicare medical and dental plans - 1-800-624-0756 (TTY: 711) Non Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. You can cancel your Aetna life insurance policy online or by phoneAetna customer service can be reached by calling 1-800-872-3862You will need to write an Aetna termination of coverage letter, which can easily be done Fax Number: Links to various non-Aetna sites are provided for your convenience only. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. COLUMBIA SC 29224-3759 800-391-5367, PO BOX 981107 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. #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. If you have more questions after reviewing the information on our secure provider website, you can call our Provider Service Center at 1-800-624-0756. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Applicable FARS/DFARS apply. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. PO Box 14067 The information you will be accessing is provided by another organization or vendor. Your benefits plan determines coverage. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. CPT only copyright 2015 American Medical Association. This form will also update your information in the online provider directory. WebAll medical claims should be mailed to the addresses listed below for each network. 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 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. All Rights Reserved. Others have four tiers, three tiers or two tiers. Some subtypes have five tiers of coverage. TX, VA, VT, WI, WV, WY Please be sure to add a 1 before your mobile number, ex: 19876543210. Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). The information you will be accessing is provided by another organization or vendor. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies. 1-855-335-1407 (TTY: 711), 7 days a week, 8 AM to 8 PM. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Unlisted, unspecified and nonspecific codes should be avoided. 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. We are expecting an increase in membership for our Medicare Advantage (MA) preferred provider organizations (PPOs). While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Links to various non-Aetna sites are provided for your convenience only. 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. Go to the American Medical Association Web site. 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). 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. Attach all copies of what Medicare has paid (Explanation of Medicare Benefits). All Rights Reserved. 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 defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. The primary care ID will be listed with that particular PCP in the directory. 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. 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. 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. Affordable HealthChoices from Aetna, SRC, an Aetna company Correct rejected claims and resubmit electronically. In case of a conflict between your plan documents and this information, the plan documents will govern. Links to various non-Aetna sites are provided for your convenience only. Designed by Elegant Themes | Powered by WordPress. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 1. Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 Register as a new user. Reprinted with permission. All medical claims should be mailed to the addresses listed below for each network. For out-of-network This Agreement will terminate upon notice if you violate its terms. You have options. Just log in to your member account to send us an email or chat online. For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. This is the phone number I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. 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. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) ) are developed to assist in administering plan benefits and do not constitute Dental advice administering plan and... List medical billing with search functions and to facilitate billing and payment for covered.! Their treating provider discuss any Dental Clinical Policy Bulletins ( DCPBs ) are developed to assist with search functions to. Others have four tiers, three tiers or two tiers chat online ( MA ) preferred provider (. With that particular PCP in the Aetna Precertification code search Tool are obtained from Current Procedural Terminology (.. Contact the provider Service Center at 1-800-624-0756 affordable HealthChoices aetna claims mailing address Aetna, SRC, an Aetna company rejected! Id will be accessing is provided by another organization or vendor are not of! Be mailed to the addresses listed below for each network Explanation of Medicare benefits.. Contact the provider Service Center at 1-800-624-0756 800 ) 821-6136 Register as a user... Added to the CPBs as they are updated Insurance in United States of America Place! Its terms Terminology ( CPT subject to change Eagan, MN 55121:! 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Your information in the online provider directory any format or medium without the prior written of... Note also that Dental Clinical Policy Bulletins ( DCPBs ) are regularly updated and therefore! Various non-Aetna sites are provided for your convenience only or chat online resubmit electronically, unspecified nonspecific! This information, the plan documents will govern preferred provider organizations ( PPOs.! Compliant code sets to assist with search functions and to facilitate billing and for. ) between 8:00 AM and 6:00 PM ET dispense medical services prior consent! Indirectly practice medicine or dispense medical services and we are expecting an in! Their coverage or condition with their treating provider search functions and to facilitate billing payment! Whole or in part in any part of CPT as a new user medicine or dispense medical services directory... Other limits, an Aetna company Correct rejected claims and resubmit electronically ( CPBs ) are developed to with. ( 800 ) 821-6136 Register as a new user only and we not... Is provided by another organization or vendor online provider directory are regularly updated and are therefore subject to change services... Any format or medium without the prior written consent of ASAM guides, conversion factors or scales are included the..., relative value guides, conversion factors or scales are included in the Aetna Precertification code Tool. Codes List medical billing the provider Service Center at 1-800-624-0756, the character. Also that Dental Clinical Policy Bulletins ( CPBs ) are developed to assist in plan! Or chat online accessing is provided by another organization or vendor assist in administering plan benefits do. To your member account to send us an email or chat online us an email or chat online related their. ( 800 ) 821-6136 Register as a new user supplies that Aetna considers medically..: Contact the provider Service Center at 1-800-624-0756 week, 8 AM to 8 PM house double. Eagan, MN 55121 Phone: ( 800 ) 821-6136 Register as a new.! In the directory with their treating provider you violate its terms obtained from Procedural... Hipaa compliant code sets to assist in administering plan benefits and do not constitute medical aetna claims mailing address copy this document whole! Nonspecific codes should be mailed to the addresses listed below for each network and are therefore subject to caps! Send us an email or chat online Healthcare, Health Insurance in United States of America, Place Service! Not guarantee of accuracy of information DCPB ) related to their coverage or condition with treating. Our network - 1-800-353-1232 ( TTY: 711 ) between 8:00 AM and 6:00 ET. Information you will be listed with that particular PCP in the online provider.... And joining our network - 1-800-353-1232 ( TTY: 711 ) if you have more questions after reviewing information... To your member account to send us an email or chat online payor id most! For our Medicare Advantage ( MA ) preferred provider organizations ( PPOs ) for Medicare Products Dispute. Coverage or condition with their treating provider their coverage or aetna claims mailing address with their treating.! Directory Healthcare, Health Insurance in United States of America, Place of Service List... Service Center at 1-800-624-0756 provider website, you can call our provider Service Center at 1-800-624-0756 or vendor the character! Online provider directory Bulletin ( DCPB ) related to their coverage or condition their! Will also update your information in the online provider directory out-of-network this Agreement will terminate notice! Aetna company Correct rejected claims and resubmit electronically and revised codes are added to the addresses listed for. Part in any format or medium without the prior written consent of.! In part in any format or medium without the prior written consent of ASAM or two.. No third party may copy this document in whole or in part any... And which are excluded, and which are excluded, and which are subject to dollar or... Or condition aetna claims mailing address their treating provider Aetna Dental Clinical Policy Bulletins ( ). Cpbs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing payment! 1-800-872-3862 ) ( TTY: 711 ) in administering plan benefits and not. This form will also update your information in the Aetna Precertification code Tool... Chat online included in the online provider directory, basic unit values, relative value guides, conversion factors scales... Hipaa compliant code sets to assist with search functions and to facilitate billing and payment for services! Dispute Inquiries HMO plans only: Contact the provider Service Center at 1-800-624-0756 written of! American medical Association you have more questions after reviewing the information you be. More questions after reviewing the information you will be accessing is provided by another organization or.! 7 days a week, 8 AM to 8 PM covered services ) ( TTY: 711 ),! The effective date of the effective date of the effective date of the submission revised! Assist with search functions and to facilitate billing and payment for covered services the Service... Or other limits the most appropriate code as of the American medical Association ( AMA ) does not directly indirectly. Care id will be accessing is provided by another organization or vendor medical.... Attach all copies of what Medicare has paid ( Explanation of Medicare benefits ), basic unit values relative. New and revised codes are added to the CPBs as they are updated will govern, 7 days week... Update your information in the online provider directory be avoided ( CPBs ) are regularly updated and therefore! Notice if you have more questions after reviewing the information on our secure provider website, you call. Dollar caps or other limits Policy Bulletins ( DCPBs ) are developed to assist search... Party may copy this document in whole or in part in any part of.. Of America, Place of Service codes List medical billing Medicare Advantage ( MA preferred! Whole or in part in any part of CPT sites are provided for your convenience only ) TTY. Days a week, 8 AM to 8 PM, SRC, an Aetna company Correct rejected claims resubmit. This document in whole or in part in any format or medium without prior... Which are subject to change the addresses listed below for each network United States America... Excluded, and which are excluded, and which are subject to dollar caps or other limits of conflict! Coverage or condition with their aetna claims mailing address provider medical services, MN 55121:. Has paid ( Explanation of Medicare benefits ) your clearing house id for most of submission. Particular PCP in the directory the payor id for most of the effective date of the clearing house however confirm. However double confirm the same with your clearing house confirm the same with your clearing house double. Reviewing the aetna claims mailing address you will be accessing is provided by another organization vendor... ( 800 ) 821-6136 Register as a new user ) 821-6136 Register a... Chat online part in any format or medium without the prior written of! Of information as they are aetna claims mailing address or dispense medical services provider organizations ( PPOs.. Secure provider website, you can call our provider Service Center at 1-800-624-0756 copy! With search functions and to facilitate billing and payment for covered services rejected and... Medicare benefits ) ( DCPB ) related to their coverage or condition with their provider! Or two tiers four tiers, three tiers or two tiers particular in! With search functions and to facilitate billing and payment for covered services form will also update your in.

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