CPT only copyright 2015 American Medical Association. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Working with providers, our advanced care management techniques help increase quality, improve efficiency . Dr. Shannitta Bridgers is a pediatric dentist at Highland Pediatric Dental in Fayetteville, SC. 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 document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. Please log in to your secure account to get what you need. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. When billing, you must use the most appropriate code as of the effective date of the submission. The information you will be accessing is provided by another organization or vendor. 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Find a Doctor :: State of Illinois - Aetna The DSNP network is in limited counties. 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. 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). You are now being directed to the CVS Health site. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Pharmacy, dental or vision providers? You can also get the materials you need in a different language or format. Exception Detail, Svc Partner Detail - When the. Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. YES - Prior authorization request is required for this service. Want to help transform health care? Please check before scheduling an appointment to make sure the provider is participating in the program. 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. Treating providers are solely responsible for medical advice and treatment of members. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Prior Authorization may be required. 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. Do you want to continue? Treating providers are solely responsible for medical advice and treatment of 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. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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 member's benefit plan determines coverage. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Please be sure to add a 1 before your mobile number, ex: 19876543210. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Go to the American Medical Association Web site. 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. Oncology treatment plans must be submitted to NantHealth via their web portal, Eviti Connect, which will expedite clinical review of any chemotherapy, radiation therapy, or supportive medications that require prior-authorization. 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. 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. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Disclaimer of Warranties and Liabilities. DocFind - Aetna Enter your location by address, city or zip code. To reduce the
ProPAT CPT Code Lookup : Aetna Better Health of Kansas Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. For children and other Medicaid members, dental providers are available through MCNA. Please review the plan benefit coverage documentation under the link below. To see if your doctor is in our network, click a plan link below. You are now being directed to CVS Caremark site. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination. Each main plan type has more than one subtype. 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). VisitVision Provider Searchto view your vision providers. This search will use the five-tier subtype. Dental Benefits | Aetna Medicaid West Virginia / Dental Benefits Provider manuals | Manuals | Aetna Better Health of Pennsylvania 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. Each plan has its own provider network. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. Aetna better health florida healthy kids. In-network coverage only (except emergency . The path to healthy starts here. 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. 2. If you do not intend to leave our site, close this message. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. 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. Helping you find the right doctor for you. Listing Websites about Aetna Better Health Dental Provider. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. You can further filter the search results by adding a specific dentist . Find a Provider | Aetna Medicaid Find the information and resources you need to meet your clients' needs. 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. Members must reside in a county where Aetna Medicare offers a DSNP. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. PA requirements are both Yes and No, as specified on the PA List. 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. Medicaid your for low-income and working humans or families, their . Links to various non-Aetna sites are provided for your convenience only. The online provider directory is updateddaily. Find a Provider | Aetna Medicaid Illinois We update our provider directory nightly. CMS requires providers to take the Model of Care training course (PDF). 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. In case of a conflict between your plan documents and this information, the plan documents will govern. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Need a new dental office home? What's covered? 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. Links to various non-Aetna sites are provided for your convenience only. Let Customer Service know the providers you called. Click here to request an office transfer. We welcome . Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Please feel free tocontact us to provide any new information. Search results are not a guarantee of claim payment. 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. Links to various non-Aetna sites are provided for your convenience only. The DSNP network is in limited counties. NON-COV - CPT or HCPCS code entered is not a covered benefit by health plan. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. 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. Links to various non-Aetna sites are provided for your convenience only. Used with express permission. 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). Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. Copyright 2015 by the American Society of Addiction Medicine. In case of a conflict between your plan documents and this information, the plan documents will govern. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). The ABA Medical Necessity Guidedoes not constitute medical advice. 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. Or they can help you find a provider. Note not all Aetna dental plans and offers available in all markets. 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. 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. 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). up to six Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding
Individual dental plan. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. All rights reserved | Email: [emailprotected], North country health care university flagstaff. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. 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. Be sure to check your email for periodic updates. Some subtypes have five tiers of coverage. 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. Of course you can use our directories to find doctors and hospitals that take your insurance. New and revised codes are added to the CPBs as they are updated. 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). Choose the type of plan you're interested in to search for health care providers that accept it. 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. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. The term prior authorization (PA) means the utilization review process determines whether the requested service, procedure, prescription drug or medical device meets the companys clinical criteria for coverage. Links to various non-Aetna sites are provided for your convenience only. Street Address: City: State: County: Zip Code: Radius: . Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Aetna Better Health Providers Pa This Agreement will terminate upon notice if you violate its terms. 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. 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. All rights reserved. Aetna international | International Medical Insurance 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. information regarding PA submission or service partner requirements. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Click here to find an in-network vision provider thats close to you. 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. Links to various non-Aetna sites are provided for your convenience only. Enter a zip code to search for dental care professionals in your area. You may also notify LIBERTY about provider directory updates by calling 888-703-6999. Click here for additional information regarding benefit coverage. Choose from the largest directory of in-person & video visit providers in the nation. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. VisitPharmacy Provider Search to view all your pharmacy providers. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. EXPIRED - CPT or HCPCS code entered is no longer valid for use by health plan providers. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. 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. . A new version of our find a dentist tool is now available for Virginia members! They also provide cosmetic services such as overlays and whitening treatments. Some subtypes have five tiers of coverage. 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). Members should discuss any matters related to their coverage or condition with their treating provider. This information is neither an offer of coverage nor medical advice. 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. 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). The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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. Directory of Dentists Treating Members with Intellectual . No fee schedules, basic unit, relative values or related listings are included in CPT. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. For more details see our Privacy Policy. Others have four tiers, three tiers or two tiers. 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. 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. All services deemed "never effective" are excluded from coverage. Health benefits and health insurance plans contain exclusions and limitations. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Find a Dentist. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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.
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