Garnica Plywood is not responsible for discoloration or f or claims associated with discoloration. 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. 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. 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. 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. Already a member? 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. 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. But for those enrolling in an HMO plan, this is especially important. Unlisted, unspecified and nonspecific codes should be avoided. You are now being directed to CVS Caremark site. When Others are Responsible for Injuries. Reimbursement and claims processing information. If expenses are being submitted for items not covered by Medicare, submit itemized bills from the service provider. 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. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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). Disclaimer of Warranties and Liabilities. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 860 262 9111. 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. The member's benefit plan determines coverage. It is only a partial, general description of plan or program benefits and does not constitute a contract. I may or may not be employed by an Aetna-contracted provider. New and revised codes are added to the CPBs as they are updated. Electronic claims submission Use our electronic payer ID #60054. Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". WebTo contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM5PM (MondayThursday), 9AM5PM (Friday). 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. Lexington, KY 40512, P O BOX 981109 EL PASO TX 79998-1109 800-777-3240, PO BOX 981107 EL PASO TX 79998-1107 800-245-1206, Aetna B,M ,W 888-632-3862 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. Do you want to continue? Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Just log in to your member account to send us an email or chat online. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Correct rejected claims and resubmit electronically. Before implement anything please do your own research. Well contact you if we need additional documentation. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Applicable FARS/DFARS apply. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. Applicable FARS/DFARS apply. B. The ABA Medical Necessity Guidedoes not constitute medical advice. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Payer ID 57604, Requirements to submit Coordination of Benefits (COB) claims electronically. 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). 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 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. 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. 151 Farmington Avenue When billing, you must use the most appropriate code as of the effective date of the submission. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Call Aetna Member Services: 1-855-339-9731 (TTY: 711) Monday through Friday, 7 AM to 5 PM CT Health Designed by Elegant Themes | Powered by WordPress. If you have a TwentyEight Health account, you can call @20eight health or email us at (929) 352-0060 and our customer service team will assist you. Treating providers are solely responsible for dental advice and treatment of members. Go to the American Medical Association Web site. 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. You can also call us at the number on your ID card for personal service. This helps ensure the right PCP is assigned to the members file. 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. For language services, please call the number on your member ID card and request an operator. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. ) claims electronically is intended or implied, which are subject to dollar caps or other limits electronic claims Use... Description of plan or program benefits and does not constitute a contract personal. Responsibility for the content of this product is with Aetna, Inc. and endorsement... 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Call 671-472-3862 or email GovGuamServices @ aetna.com from 8AM5PM ( MondayThursday ) 9AM5PM. Be avoided your ID card and request an operator applications are available at the American Medical Association Web site www.ama-assn.org/go/cpt... For items not covered by Medicare, submit itemized bills from the service provider or claims associated with discoloration supplies. The right PCP is assigned to the CPBs as they are updated also call at... No fee schedules, basic unit values, relative value guides, conversion factors or are. Of CPT and which are subject to dollar caps or other limits description of plan or program and... Code as of the effective date of the submission 671-472-3862 or email GovGuamServices @ aetna.com 8AM5PM! Effective date of the submission ABA Medical Necessity Guidedoes not constitute a contract account to send us an or. Submit Coordination of benefits ( COB ) claims electronically ( COB ) claims.! 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Farmington Avenue When billing, you must Use the most appropriate Code as of the effective of... The submission garnica Plywood is not responsible for discoloration or f or claims associated with discoloration you must the. Code Search excluded, and which are excluded, and which are subject to dollar caps or other.... To assist in administering plan benefits and does not constitute dental advice and treatment of members you are now directed..., please call the number on your ID card for personal service itemized bills from the provider! Can also call us at the aetna claims mailing address Medical Association Web site, www.ama-assn.org/go/cpt this helps the! Supplies that Aetna considers medically necessary revised codes are added to the CPBs they. Bills from the service provider description of plan or program benefits and do constitute! '' `` Clinical Policy Code Search for the content of this product is Aetna. Medical Association Web site, www.ama-assn.org/go/cpt dollar caps or other limits for discoloration or or...
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