This search will use the five-tier subtype. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Depending on the members MSP eligibility, they may have a cost-share responsibility. 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. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. New and revised codes are added to the CPBs as they are updated. 2022 Dual Eligible Special Needs Plans (DSNPs) information, Required Centers for Medicare & Medicaid Services (CMS) training, Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, OfficeLink Updates Newsletters Medicare Updates, Aetna Better Health of Virginia provider search page, Aetna Assure Premier Plus provider search page. If you wish to make a standing request to receive all materials in a language other than English or in an alternate format, you can call Aetna Better Health ofLouisiana Member Services at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. CPT only copyright 2015 American Medical Association. Reprinted with permission. Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. To reduce the 2023 DentalPlans.com, Inc. All Rights Reserved. Unrivaled access to care in 200+ countries and territories around the world. 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. Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination. For enhanced adults benefit, visitDental Provider Searchto view your dental providers. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. Go to the American Medical Association Web site. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. The online provider directory is updateddaily. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. 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. Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. Applicable FARS/DFARS apply. Dr. Shannitta Bridgers is a pediatric dentist at Highland Pediatric Dental in Fayetteville, SC. If you do not intend to leave our site, close this message. This list is updated nightly. For children and other Medicaid members, dental providers are available through MCNA. Or they can help you find a provider. 2/22). While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Address, phone number, and practice changes. Were expanding our DSNP program into more markets for 2022. Click here to let us know so we can fix it. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Louisiana, All Rights Reserved. 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. For more details see our Privacy Policy. 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). The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. For children and other Medicaid members, dental providers are available through MCNA. 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. 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. WebAetna Better Health of Maryland Medicaid Dental Provider Search. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Provider site; Please america; Search. Looking for a local dentist? INVALID - CPT or HCPCS code entered was invalid, not found. No fee schedules, basic unit, relative values or related listings are included in CPT. Health benefits and health insurance plans contain exclusions and limitations. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Please correct the following errors and try again: Fill out this form to find providers and health care facilities near you. Go to the American Medical Association Web site. 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. System (HCPCS) codes or a CPT group and select SEARCH. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You are now being directed to the CVS Health site. Health. Links to various non-Aetna sites are provided for your convenience only. They also provide cosmetic services such as overlays and whitening treatments. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. It provides benefits to members who qualify for Medicare and who receive full Medicaid benefits and/or assistance with Medicare premiums or Medicare Parts A & B cost sharing through one of the Medicare Savings Program (MSP) categories. We work with physicians to develop common platforms and goals, shifting the focus from episodes of care to making patient populations healthier. Aetna has one of the nation's largest dental networks, with more than 200,000 participating dental practices, making it easy to find a great dentist or specialist near you. Please contact Access2Care for benefit information by calling 1-866-252-5634 or visit www.Access2Care.net. 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 term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. 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. Access2Care performs transportation management services on behalf of Aetna Better Health. 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. 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. 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 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. Enter your location by address, city or zip code. Links to various non-Aetna sites are provided for your convenience only. Pharmacy, dental or vision providers? 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). General Dentists: provide all the services you need to maintain healthy teeth and gums. Please review the plan benefit coverage documentation under the link below. Select a Plan * Select a Plan: 2. Listing Websites about Aetna Better Health Dental Provider. Aetna Better Health. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Others have four tiers, three tiers or two tiers. Unlisted, unspecified and nonspecific codes should be avoided. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. No fee schedules, basic unit, relative values or related listings are included in CPT. Visit our Medicare page for more DSNP resources, including cost-share information. Are you looking for free COVID-19 testing providers? Your Plan: Your Plan: 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. A new version of our find a dentist tool is now available for Illinois members! Links to various non-Aetna sites are provided for your convenience only. 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 five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (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. To get started: 1. You are now being directed to CVS caremark site. All Rights Reserved. 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. 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. CPT is a registered trademark of the American Medical Association. Find your plan listed below and click Find a Dentist. The ABA Medical Necessity Guidedoes not constitute medical advice. *Required Selections. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. CPT only Copyright 2022 American Medical Association. Some subtypes have five tiers of coverage. Each main plan type has more than one subtype. LIBERTY makes certain language assistance services available to you at no cost. Join today and elevate your smile for less than you ever dreamed was possible. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. . Find a Provider. Links to various non-Aetna sites are provided for your convenience only. Some subtypes have five tiers of coverage. #2020 . Unlisted, unspecified and nonspecific codes should be avoided. Providers may not balance bill members who do not have cost-share responsibility (including QMB-only). Treating providers are solely responsible for medical advice and treatment of members. logo Aethna Better Health of West Virginia. 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. Idaho Members: If you contact several providers who have indicated they will see new patients and find you cannot get an appointment, you may call Customer Service at 1-800-936-0978. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. To check that your provider participates, visit our website or call us. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Members must select a primary care physician. 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. 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. We update our provider directory nightly. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. 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. The member's benefit plan determines coverage. Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. The member's benefit plan determines coverage. Health benefits and health insurance plans contain exclusions and limitations. 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. The dental discounts are available through participating healthcare providers only. It provides coverage for a wide range of dental services, including . Some subtypes have five tiers of coverage. Find a Dentist. It is only a partial, general description of plan or program benefits and does not constitute a contract. Request an Office Transfer. All rights reserved. Just scroll down to "Find local care. 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). 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). Or they can help you find a provider. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. Dental Providers: Register now for AetnaDental.com Medical Providers: Register for Aetna's Provider portal on Availity: Do you want to continue? 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. 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. 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. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. A DSNP is a special type of Aetna Medicare Advantage Prescription Drug (MAPD) plan. Links to various non-Aetna sites are provided for your convenience only. Copyright 2015 by the American Society of Addiction Medicine. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. This information helps us provide information tailored to your Medicare eligibility, which is based on age. Treating providers are solely responsible for dental advice and treatment of members. Benefit coverage may vary by plan or may be subject to special conditions. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. This information is neither an offer of coverage nor medical advice. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Your plan may only provide benefits if you obtain a referral from your General Dentist prior to receiving treatment from a Specialist. Our find a dentist tool includes a brief survey to help us improve this service. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. #2020-93661 (exp. Applicable FARS/DFARS apply. Your benefits plan determines coverage. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. If you have questions, visit our contact us page. Please be sure to add a 1 before your mobile number, ex: 19876543210. Orthodontists: correct the position of misaligned teeth and jaws, typically this is done with braces although treatments using other dental devices (such as retainers) are also utilized. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 2020 Guardian. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Please feel free tocontact us to provide any new information. and you keep saving there is no maximum annual spending limit! Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Due to the impact of the COVID-19 pandemic, many provider offices may need to adjust their office hours or redirect patients to others offices. 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. ALL inpatient confinements require PA and usually ALL services provided . Visit the secure website, available through www.aetna.com, for more information. Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. VisitPharmacy Provider Search to view all your pharmacy providers. 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. If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. If your patient has primary Medicare coverage outside of Aetna Better Health Premier Plan, please call the Medicare plan for benefits and authorization requirements. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. When billing, you must use the most appropriate code as of the effective date of the submission. All rights reserved | Email: [emailprotected], North country health care university flagstaff. Aetna Inc. and its subsidiary 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. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. All services deemed "never effective" are excluded from coverage. Learn more about our dental advantages. Go to the American Medical Association Web site. All Rights Reserved. You can get a copy of the provider directory by mail. You can also get the materials you need in a different language or format. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. 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. Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. 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?. 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. 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. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Links to various non-Aetna sites are provided for your convenience only. 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. Click here to find an in-network pharmacy provider thats close to you. Click here for additional information regarding benefit coverage. ", Provider/facility name OR specialty is required to continue.
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