Click here to find an in-network pharmacy provider thats close to you. 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. 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. 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. You will receive the discount off the providers usual and customary fees when you pay. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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 member's benefit plan determines coverage. Address, phone number, and practice changes. Please be sure to add a 1 before your mobile number, ex: 19876543210. 2023 DentalPlans.com, Inc. All Rights Reserved. Your Plan: Your Plan: If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health Provider Relations at 1-855-364-0974. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. 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. Enter your location by address, city or zip code. Links to various non-Aetna sites are provided for your convenience only. 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. 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. Find a Dentist. Click here for additional information regarding benefit coverage. Did you find information that you think may need to be updated in our provider directories? The ABA Medical Necessity Guidedoes not constitute medical advice. 1. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You are now being directed to the CVS Health site. Listing Websites about Aetna Better Health Dental Provider. 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. 1367 Walter Reed Rd, 103, Fayetteville, NC 28304. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. Links to various non-Aetna sites are provided for your convenience only. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Applicable FARS/DFARS apply. AetnaDentalOffers.com is brought to you by DentalPlans.com. When making an appointment, please be sure your provider offers all services you may need, Avsis Incorporated and Avsis Third Party Administrators, Inc. (Avsis), are wholly owned subsidiaries of Guardian. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Besides treating dental conditions, she educates her young patients on the importance of proper dental health and dispenses practical advice on maintaining dental hygiene. Or they can help you find a provider. The NJFC Directory of Dentists Treating Children under the Age of 6. 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. VisitPharmacy Provider Search to view all your pharmacy providers. You are now being directed to CVS Caremark site. Family planning, Emergent and Urgent Care services do not require PA. 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. Future changes to CPT or Healthcare Common Procedure Coding System (HCPCS) codes that require PA will be communicated by Aetna Better Health Premier Plan in writing and on the homepage of Aetna Better Healths secure web portal. Medicaid your for low-income and working humans or families, their . 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Street Address: City: State: County: Zip Code: Radius: . Members should always contact the provider's office in advance to confirm availability. Go to the American Medical Association Web site. Aetna Better Health of Louisianais 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 five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. 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. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Need a new dental office home? By submitting your information you are agreeing to receive communications from Aetna Dental Offers. 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. 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. Check your participation status using the provider search tool. Click here to request an office transfer. The DSNP network is in limited counties. Please log in to your secure account to get what you need. Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. New and revised codes are added to the CPBs as they are updated. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. Each main plan type has more than one subtype. Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . 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. ", Provider/facility name OR specialty is required to continue. 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. Members must reside in a county where Aetna Medicare offers a DSNP. For children and other Medicaid members, dental providers are available through MCNA. CPT is a registered trademark of the American Medical Association. You may opt out at any time. Want to help transform health 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). If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Visit the secure website, available through www.aetna.com, for more information. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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). Prosthodontists: restore damaged teeth or replace missing ones, with procedures that include dental implants, bridges, crowns and dentures. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. You also can look for more than 25 other types of health care providers, including pharmacies, marriage counselors, urgent care centers, acupuncturists, drug and alcohol counselors, hospice care providers, dialysis centers, vision care providers, flu shot providers and physical therapists. You may also notify LIBERTY about provider directory updates by calling 888-703-6999. You are now being directed to the CVS Health site. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan Endodontists: help heal infections of the soft tissue inside the tooth and are typically the dental specialist youd see if you need a root canal treatment. and you keep saving there is no maximum annual spending limit! #2020-93661 (exp. Skip to main content . In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Links to various non-Aetna sites are provided for your convenience only. *Required Selections. 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. Do you want to continue? Provider Directory Aetna Better Health of Pennsylvania. To help us direct your question or comment to the correct area, please select a category below. 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. Pharmacy, dental or vision providers? Visit the secure website, available through www.aetna.com, for more information. 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. The path to healthy starts here. Aetna offers health insurance, as well as dental, vision and other plans, to meet the needs of individuals and families, employers, health care providers and insurance agents/brokers. Each plan has its own provider network. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 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. Please note that providers listed in this directory may perform services that are not covered by your health plan. Links to various non-Aetna sites are provided for your convenience only. Applicable FARS/DFARS apply. 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. You can also get the materials you need in a different language or format. Treating providers are solely responsible for medical advice and treatment of members. It is only a partial, general description of plan or program benefits and does not constitute a contract. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Aetnamedicare.blob.core.windows.net. 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. 1. 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. Please log in to your secure account to get what you need. 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. They also provide cosmetic services such as overlays and whitening treatments. It provides coverage for a wide range of dental services, including . 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. . When billing, you must use the most appropriate code as of the effective date of the submission. It is only a partial, general description of plan or program benefits and does not constitute a contract. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. * Enter Provider ID : * Enter NPI : *Provider Type : Select a Provider Type Medical (Includes Behavioral Health) Dental Facilities. 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). All Rights Reserved. Links to various non-Aetna sites are provided for your convenience only. Helping you find the right doctor for you. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical 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. 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. CPT only Copyright 2022 American Medical Association. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Prior Authorization may be required. Search result definitions: NOTE: When selecting by CPT group, the results displayed include CPT codes where
No fee schedules, basic unit, relative values or related listings are included in CPT. Provider/Facility Name OR Specialty is required to continue, Please enter first and last name of Provider, or the name of the facility. Links to various non-Aetna sites are provided for your convenience only. Please review the plan benefit coverage documentation under the link below. Links to various non-Aetna sites are provided for your convenience only. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Others have four tiers, three tiers or two tiers. This information is neither an offer of coverage nor medical advice. CPT is a registered trademark of the American Medical Association. 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. The information you will be accessing is provided by another organization or vendor. 2020 Guardian. Please enable it to continue. symbol is displayed for the code, place your cursor over the symbol to review additional
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