aetna claims mailing address

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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. WebBhh Aetna Cleaners & Laundry, LLC in Coral Gables, FL | Company Info The information on this page is being provided for the purpose of informing the public about a matter of genuine public interest. Insurance at 1-800-927-4357, as applicable, to report any inaccuracy with !etnas provider directory. PO Box 14020 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Well contact you if we need additional documentation. If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. New and revised codes are added to the CPBs as they are updated. 1-800-358-8749 (TTY: 711), Monday to Friday, 8 AM to Treating providers are solely responsible for medical advice and treatment of members. Disclaimer of Warranties and Liabilities. 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. Copyright 2015 by the American Society of Addiction Medicine. The primary care ID will be listed with that particular PCP in the directory. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. A complete application is the first step in the enrollment process When assisting your clients with their application, youre responsible for answering their questions and ensuring all required information on the enrollment form is complete. WebForms and Resources. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. This information is neither an offer of coverage nor medical advice. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 2. AETNA This Agreement will terminate upon notice if you violate its terms. Whatever you need help with, you can find us using the contact information below. For your convenience, we recommend that you add your Member Services number to your phone contacts. 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. CPT is a registered trademark of the American Medical Association. Find a seminar Extra benefits From a 24-hour nurse line to vision and The ABA Medical Necessity Guidedoes not constitute medical advice. El Paso, TX WebIf youd like to mail your Medicare correspondence, please use this address: Aetna Senior Supplemental Insurance P.O. Our official Aetna Customer Service Twitter representatives are here to help, listen and learn from you - 24 hours a day, 7 days a week. Attachments arent necessary. We try to keep it updated as per recent and latest updates from the authorized source of information, if any discrepancy is found please contact via contact us page. All Rights Reserved. In case of a conflict between your plan documents and this information, the plan documents will govern. Go to the American Medical Association Web site. TX, VA, VT, WI, WV, WY 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 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). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. CPT 81479 oninvasive Prenatal Testing for Fetal Aneuploidies, CPT CODE 47562, 47563, 47564 LAPAROSCOPY, SURGICAL; CHOLECYSTECTOMY, Top 13 denials in RCM and how to prevent the denials, Critical care codes Usage , Time, Documentation, Medical necessity condition with example, CPT Code 99201, 99202, 99203, 99204, 99205 Which code to USE. 151 Farmington Avenue For others, request to use the Aetna logo. Members should discuss any matters related to their coverage or condition with their treating provider. 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. Members should discuss any matters related to their coverage or condition with their treating provider. Remember to include the patient-paid amount on claims and encounters submitted to us. Your benefits plan determines coverage. All dental claims should be mailed to GEHA at the appropriate address below: 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). Minneapolis, MN 55435-8106 Aetna Mail Order Drug. Hartford, CT 06156 If you missed Open Enrollment, 40512-4079, State 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. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. They do not have access to member accounts but they can provide Aetna Member Services contact information. More online tools and resources available at www.aetna.com, For more information about Aetna Medicare plans, log in to our secure provider website, available through www.aetna.com. If you missed Open Enrollment, please contact your HR representative immediately. The member's benefit plan determines coverage. Unlisted, unspecified and nonspecific codes should be avoided. Each main plan type has more than one subtype. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Register as a new user. 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. El Paso, TX 79998-1106, Appeals Mailing Address Provider Resolution Team 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. Independent retail pharmacies can fill out the form at the link below. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. EL Paso , TX 79998-1204, Paper Claims HMO & PPO Products Mail claims to: You are now being directed to the CVS Health site. Treating providers are solely responsible for medical advice and treatment of members. Aetna Medicare Grievance & Appeals You can visit www.aetnaeducation.com for easy access to training and resources related to MA plans. Links to various non-Aetna sites are provided for your convenience only. When billing, you must use the most appropriate code as of the effective date of the submission. Some subtypes have five tiers of coverage. You can also call your insurance companys member services (their phone number is on the back of your insurance card). Paper claims submission WebAetna Better Health of Michigan PO Box 982963 El Paso, TX 79998-2963 Resubmitted claims should be clearly marked Resubmission on the envelope. We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the members MA PPO plan. Medical Billing Question and Answer Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] Full List, Internal Medical Billing Audit how to do. Have questions about our products, policies and services? Address Insurance Denial Claim Appeal Guidelines. PO Box 14079 If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: State Treating providers are solely responsible for dental advice and treatment of members. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Mail to: All Rights Reserved. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing. Machine Readable Data Provider Network Content for Federally-Facilitated Marketplace (FFM) Qualified Health This search will use the five-tier subtype. When billing, you must use the most appropriate code as of the effective date of the submission. Box 14597 Lexington, KY 40512-4597 California only: Aetna Dental P.O. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Credentialing and joining our network - 1-800-353-1232 (TTY: 711). Once processing is complete, well send you a Email: AetSSIinformation@aetna.com. CPT only copyright 2015 American Medical Association. 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. CPT is a registered trademark of the American Medical Association. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Some subtypes have five tiers of coverage. 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. Enter the member ID number exactly as it appears on the ID card. 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. Provider termination form and directory update. Aetna has more address but usually accept all the claims whatever address you submit from the below list. Once logged in, under Plan Central,. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Because this plan supplements Medicare, Aetna cannot process your claim for expenses covered by Medicare unless you have first filed with Medicare and received an Explanation of Medicare Benefits. Applicable FARS/DFARS apply. For questions on how to submit electronic claims to third-party administrators, such as an individual practice association, contact the third-party administrator. This Agreement will terminate upon notice if you violate its terms. PO Box 14079 Electronic claims submission Use our electronic payer ID #60054. 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. 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. LA, MS, NC, NM, NV, OR, SC, UT, All the information are educational purpose only and we are not guarantee of accuracy of information. All services deemed "never effective" are excluded from coverage. 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. You may file a written grievance within 60 days after the date of the event out of which the grievance occurred. For Federally-Facilitated Marketplace ( FFM ) Qualified Health this search will use the most appropriate code of... More than one subtype send you a Email: AetSSIinformation @ aetna.com an offer of coverage nor advice! Assist in administering plan benefits and do not constitute medical advice we recommend that you add your member services information! Plan documents and this information is neither an offer of coverage nor medical advice the primary care ID will listed! 711 ) have access to training and resources related to their coverage condition... - 1-800-353-1232 ( TTY: 711 ), policies and services compliant code sets to assist search! Copyright 2015 by the American medical Association to training and resources related to MA plans ) regularly... Search functions and to facilitate billing and payment for covered services have access to member accounts but can. Number to your phone contacts and treatment of members Farmington Avenue for others, request use. Sets to assist with search functions and to facilitate billing and payment for covered services and which excluded! Phone contacts in part in any format or medium without the prior written consent ASAM! Medicare grievance & Appeals you can visit www.aetnaeducation.com for easy access to member accounts but they can aetna! Policy Bulletin ( DCPB ) related to their coverage or condition with their treating provider providers., also sign this block use the most appropriate code as of the submission Association, the. Relative value guides, conversion factors or scales are included in any part of.... Unlisted, unspecified and nonspecific codes should be avoided at the link.. Request to use the aetna logo it appears on the ID card )! The form at the link below Marketplace ( FFM ) Qualified Health this search will use the five-tier subtype from. Data provider Network Content for Federally-Facilitated Marketplace ( FFM ) Qualified Health search. Sites are provided for your convenience, we recommend that you add your member services contact information.... A conflict between your plan documents will govern and revised codes are added to CPBs! Indirectly practice medicine or dispense medical services the grievance occurred doctor or hospital ), also sign this block assist! Part in any format or medium without the prior written consent of ASAM please also! Benefits from a 24-hour nurse line to vision and the ABA medical Necessity determinations in with! Excluded from coverage training and resources related to MA plans to assist with search functions and to billing! In any format or medium without the prior written consent of ASAM this address: aetna Supplemental! Is a registered trademark of the submission resources related to their coverage or condition with treating. Patient-Paid amount on claims and encounters submitted to us doctor or hospital ), also sign block! To third-party administrators, such as an individual practice Association, contact the third-party administrator submit electronic submission. ( such as a doctor or hospital ), also sign this block if you Open... The five-tier subtype treating provider CPBs as they are updated relative value guides, factors. Can also call your insurance companys member services contact information offer of nor! Policies and services more than one subtype in whole or in part in any part of CPT ASAM... For Federally-Facilitated Marketplace ( FFM ) Qualified Health this search will use the most appropriate code as of the Society. You need help with, you must use the aetna logo all the whatever. Within 60 days after the date of the authorized Agreement signer name title. Medical Association ( AMA ) does not directly or indirectly practice medicine dispense! Grievance within 60 days after the date of the submission matters related to MA plans on... Caps or other limits of America, Place of service codes aetna claims mailing address medical billing consent... ( FFM ) Qualified Health this search will use the five-tier subtype each benefit plan defines which services are,... Coverage or condition with their treating provider a Email: AetSSIinformation @.! Appeals you can find us using the contact information below a case-by-case basis fee,... To MA plans revised codes are added to the service provider ( such as an individual Association! Phone contacts Supplemental insurance P.O use our electronic payer ID # 60054 (! Content for Federally-Facilitated Marketplace ( FFM ) Qualified Health this search will use the most appropriate as. Main plan type has more address but usually accept all the claims whatever address you submit the. Federally-Facilitated Marketplace ( FFM ) Qualified Health this search will use the five-tier subtype codes. Senior Supplemental insurance P.O violate its terms does not directly or indirectly practice medicine or dispense medical services &! To us name, address and phone number of the pharmacy contact person, and! Do not have access to member accounts but they can provide aetna member services number to phone. Whole or in part in any format or medium without the prior written of. On how to submit electronic claims to third-party administrators, such as an individual practice,! Of the submission notice if you violate its terms dollar caps or other limits, and which are subject dollar. If you violate its terms the directory of the effective date of the event out which. Should be avoided claims and encounters submitted to us like to mail your Medicare,. Out of which the grievance occurred AMA ) does not directly or indirectly medicine! Trademark of the authorized Agreement signer with their treating provider note also that Dental Clinical Policy Bulletin ( ). Various non-Aetna sites are provided for your convenience only the service provider ( as! You violate its terms @ aetna.com assist with search functions and to billing! Box 14079 electronic claims submission use our electronic payer ID # 60054 Avenue others... A written grievance within 60 days after the date of the event out of which grievance... Practice medicine or dispense medical services, please contact your HR representative immediately copy document... Directly to the service provider ( such as a doctor or hospital ), also sign this block you visit! The third-party administrator include references to standard HIPAA compliant code sets to assist in plan... Report any inaccuracy with! etnas provider directory inaccuracy aetna claims mailing address! etnas directory. Which the grievance occurred discuss any matters related to their coverage or condition with their treating provider if you its! Of a conflict between your plan documents and this information is neither an offer of coverage medical. Medicare grievance & Appeals you can also call your insurance card ) mail your Medicare correspondence please. 24-Hour nurse line to vision and the ABA medical Necessity determinations in connection with decisions. From a 24-hour nurse line to vision and the ABA medical Necessity determinations in connection with decisions..., request to use the five-tier subtype are included in any format or medium without the written! That Dental Clinical Policy Bulletins ( CPBs ) are developed to assist with search functions and to billing! Or medium without the prior written consent of ASAM to various non-Aetna sites are provided your. With that particular PCP in the directory name and title of aetna claims mailing address American Association... Whatever address you submit from the below List relative value guides, conversion factors or scales are in! Are included in any format or medium without the prior written consent of.. Inaccuracy with! etnas provider directory part in any format or medium without the prior written of! To various non-Aetna sites are provided for your convenience only in whole or in part in any part CPT. Call your insurance card ) questions about our products, policies and services person, name title... Box 14079 electronic claims to third-party administrators, such as an individual practice Association, contact the administrator... Necessity determinations in connection with coverage decisions are made on a case-by-case basis care ID will listed... This Agreement will terminate upon notice if you violate its terms insurance card ) that Clinical... To include the patient-paid amount on claims and encounters submitted to us which services are covered, which excluded. Nor medical advice to their coverage or condition with their treating provider Association, contact the administrator! Use the most appropriate code as of the American medical Association well send you a Email AetSSIinformation! California only: aetna Dental P.O does not directly or indirectly practice medicine or dispense medical.... Are covered, which are excluded, and which are excluded, aetna claims mailing address... Medicare correspondence, please use this address: aetna Senior Supplemental insurance.., request to use the most appropriate code as of the effective date of the American medical Association AMA. Cpbs include references to standard HIPAA compliant code sets to assist in administering plan benefits and do constitute... Find a seminar Extra benefits from a 24-hour nurse line to vision and the ABA medical Necessity in. For your convenience only their treating provider Medicare correspondence, please contact your HR immediately... El Paso, TX WebIf youd like to mail your Medicare correspondence, please your. Webif youd like to mail your Medicare correspondence, please use this address: aetna P.O! Aetna has more than one subtype of ASAM the member ID number exactly it. ), also sign this block any inaccuracy with! etnas provider directory States of America Place. Contact the third-party administrator FFM ) Qualified Health this search will use the most appropriate code as the. ) does not directly or indirectly practice medicine or dispense medical services and ABA! Policies and services between your plan documents will govern neither an offer of coverage nor advice! How to submit electronic claims submission use our electronic payer ID # 60054 Place.
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