All DSNP plans are required to have an approved Model of Care. Click here to find an in-network dental provider thats close to you. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. We work with physicians to develop common platforms and goals, shifting the focus from episodes of care to making patient populations healthier. Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. 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. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Health (3 days ago) Webfor a provider. 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. Experience and expertise to help our customers and members navigate the complex global health care landscape. The member's benefit plan determines coverage. Used with express permission. Pharmacy, dental or vision providers? A new version of our find a dentist tool is now available for Illinois members! We're sorry but Provider Locator doesn't work properly without JavaScript enabled. Treating providers are solely responsible for medical advice and treatment of members. 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. Find a Provider | Aetna Medicaid Illinois Find a Dentist. Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. This Agreement will terminate upon notice if you violate its terms. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. If you are looking for a specific provider and cannot find them online, need more information,help, or would like a printed copy of the provider directory mailed to you,callus at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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). Others have four tiers, three tiers or two tiers. 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. Note not all plans and offers available in all markets. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Go to the American Medical Association Web site. For language services, please call the number on your member ID card and request an operator. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. 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). If you do not intend to leave our site, close this message. Disclaimer of Warranties and Liabilities. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. Select a Plan * Select a Plan: 2. Enter your location by address, city or zip code. 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. DocFind - Aetna You can get dental care when you join Aetna Better Health of West Virginia. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("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 enhanced adults benefit, visit Dental Provider Search to view your dental providers. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". You are now being directed to CVS Caremark site. logo Aethna Better Health of West Virginia. Check your participation status using the provider search tool. WebAetna Better Health of Maryland Medicaid Dental Provider Search. Copyright 2015 by the American Society of Addiction Medicine. Aetna Better Health - LIBERTY Dental Plan 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. #2020 . 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Provider/Facility Name OR Specialty is required to continue, Please enter first and last name of Provider, or the name of the facility. 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. From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. For enhanced adults benefit, visitDental Provider Searchto view your dental providers. This information is neither an offer of coverage nor medical advice. 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 call Aetna Better Health of Louisiana Member Services at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Treating providers are solely responsible for medical advice and treatment of members. 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. Aetna Better Health Providers Pa Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. When billing, you must use the most appropriate code as of the effective date of the submission. ProPAT CPT Code Lookup : Aetna Better Health To check that your provider participates, visit our website or call us. CMS requires providers to take the Model of Care training course (PDF). Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Health benefits and health insurance plans contain exclusions and limitations. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Explore Medicaid benefits and added services. Join our team. 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). Treating providers are solely responsible for dental advice and treatment of members. Check your participation status using the provider search tool. Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. 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. Aetna better health florida healthy kids. Click here to find an in-network pharmacy provider thats close to you. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Find a Provider. The ABA Medical Necessity Guidedoes not constitute medical advice. In-network coverage only (except emergency . CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Please log in to your secure account to get what you need. For language services, please call the number on your member ID card and request an operator. 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. Be sure to check your email for periodic updates. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Please feel free tocontact us to provide any new information. A new version of our find a dentist tool is now available for Virginia members! Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Links to various non-Aetna sites are provided for your convenience only. This information helps us provide information tailored to your Medicare eligibility, which is based on age. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 2. Links to various non-Aetna sites are provided for your convenience only. Find A Dentist - DentaQuest 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 HMO plan is ideal for employers in urban locations who want to offer simple, convenient care with fixed, predictable costs. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. System (HCPCS) codes or a CPT group and select SEARCH. Reprinted with permission. 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. Applicable FARS/DFARS apply. *Required Selections. Best Aetna Pediatric Dentists Near Me | Zocdoc Did you find information that you think may need to be updated in our provider directories? 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. Choose the type of plan you're interested in to search for health care providers that accept it. Each main plan type has more than one subtype. Request a medical application. 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. Aetna 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. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. up to six Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding 2/22). Applicable FARS/DFARS apply. Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. CPT only copyright 2015 American Medical Association. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. PA requirements are both Yes and No, as specified on the PA List. 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). 2023 LIBERTY Dental Plan, All Rights Reserved. Medicaid your for low-income and working humans or families, their . New and revised codes are added to the CPBs as they are updated. 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. Depending on the members MSP eligibility, they may have a cost-share responsibility. Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. Please log in to your secure account to get what you need.