It is important to note that not all of the Sutter Health network of providers necessarily participate in all of a health plan's products or networks. However, if you visit an out-of-network provider, its a little more tricky. Precertification Request Clinical Update Request Welcome to the Meritain Health benefits program. With Aetna's financial backing and 30-plus years of operational excellence, you can rest assured knowing Meritain Health has the experience and resources to keep your plan. Members should discuss any matters related to their coverage or condition with their treating provider. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. trademark of Sutter Health , Reg. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. All Rights Reserved. All services deemed "never effective" are excluded from coverage. WEX Health Inc. 2004-2023. Copyright 2023 Meritain Health. All rights reserved | Email: [emailprotected], Healthcare information security certification, Dc department of health and licensing search, Washington state mental health license lookup, Car insurance for healthcare professionals. Links to various non-Aetna sites are provided for your convenience only. Cookie Preferences. Combined with our own in-house products and valued vendor partnerships, our solutions have placed us as the second largest third party administrator (TPA) in the nation. Call-back available NO. I practice independently and I want to contract with Aetna. 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). Gather Information. 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. www.meritain.com . In case of a conflict between your plan documents and this information, the plan documents will govern. Copyright 2023 Meritain Health. Prompt claims payment Youll benefit from our commitment to service , Health (1 days ago) WebMeritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Call picked up by a real person YES. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Treating providers are solely responsible for dental advice and treatment of members. We are excited to share that MeridianCare, a WellCare company, is , Health (Just Now) WebEnsure that the details you fill in Meritain Benefit Enrollment Form Fillable is up-to-date and correct. These providers have agreed to discounted rates for the services they offer. You can also check out our informational video about the advantages of using in-network providers. 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. Disclaimer of Warranties and Liabilities. Clicking this button will cancel username recovery and navigate to login page Clicking this button will navigate to the next page Continue Join CAQH UPD. First, you can request participation in the Aetna network by completing , Understanding asian culture in healthcare, How does culture affect health and wellbeing, Home health conditions of participation 2023, 2022 health-mental.org. Torequest participation in First Health networks, follow the link below. Online Certification Process Provider services - Meritain Health Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. The CAQH Unique provider data source is an online tool that conveniently gathers information required by health plans to obtain provider credentialing. 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. ProfilePoints measure the overall completeness of a This Aetna provider , https://www.aetna.com/docfind/jsp/rdIndex.jsp?site_id=mymeritain&langpref=en, Health (5 days ago) WebHere's how it works: Step 1. We use cookies and limited processing of your personal information for our Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. **Please select one of the options at the left to proceed with your request. 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, 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. Were a proud subsidiary of Aetna and CVS Health. 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). Our trusted partnership will afford you and your practice a healthy dose of advantages. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. provider's profile, including items like having a photo, a biography, This means you could end up having to pay a lot more for your care. All Time Meritain Health Customer Service When you need more information We are Meritain Health As Advocates for Healthier Living, we provide easy-to-use health care benefits you can use to live well. 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. Very professional. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Were a proud subsidiary of Aetna and CVS Health . Meritain Health works closely with provider networks, large and small, across the nation. What is an in-network provider? Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. Why to Visit Doctors in Your Provider Network, Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health, All About Spending Accounts: HRAs, FSAs and HSAs, The Importance of Good Financial Wellness. This site has been specially designed to provide quick and easy access to the Aetna provider directory. 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. Precertification Request. 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. U.S. Patent & Trademark office. Contact Us | Meridian Treating providers are solely responsible for medical advice and treatment of members. insurance, payment options, etc. After-hours, weekend and holiday services. Our trusted partnership will afford you and your practice a healthy , https://www.meritain.com/resources-for-providers-meritain-health-provider-portal/, Health (3 days ago) WebAt Meritain Health, we create unrivaled connections. We're currently processing your request and we'll be in touch soon. Provider services Contact us Your patient's health and your ability to access their information is important to us. When you visit an out-of-network provider, its common to pay up front and then file a claim for reimbursement according to your out-of-network benefits (if this is part of your plan coverage). Copyright 2015 by the American Society of Addiction Medicine. You can email the site owner to let them know you were blocked. 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. Please check with your health plan if you have questions about coverage and network providers for specific products. Find a Northern Californian Provider that meets your needs. Welcome to Meritain Health At Meritain Health, we create unrivaled connections. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. Check-ups, screenings and sick visits for adults and children. Meritain Health Member Services - Meritain Health Cobrowse. They go above and, Trusted Advisors Since 1984. But if youre wondering why to visit doctors in your provider network, you may question how much it actually matters. 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. This website is using a security service to protect itself from online attacks. All rights reserved. Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. Were a proud subsidiary of Aetna and CVS Health . Please log in to your secure account to get what you need. 437 verified reviews. This means we can connect you to over 700,000 providers nationwide, unmatched network , Health (Just Now) WebWelcome to Meritain Health's Aetna DocFind site. 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. Click to reveal Meritain Health offers the resources of a national carrier combined with unmatched flexibility and plan options. We are excited to share that MeridianCare, a WellCare company, is , https://corp.mhplan.com/en/join-our-network/, Health (Just Now) WebWelcome to Meritain Health's Aetna DocFind site. Health benefits and health insurance plans contain exclusions and limitations. You can learn more by contacting the Customer Service department of your benefits plan. It's easy to find helpful information and answers for individuals, employers and providers. And our payment, financial and procedural accuracy is above 99 percent. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Category: Health Detail Health. Information obtained during the , Health WebCredentialing Process Overview . While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Include the date to the template using the Date feature. Skip To Main Content. Gwizdala & Associates offers tax, bookkeeping and. Total number of Providers on Doctor.com who Accept Meritain Health: Most popular medical specialty of providers who accept Meritain Health: Meritain Health providers listed on Doctor.com have been practicing for an average of: Average ProfilePoints score for Providers who take Meritain Health: Average Overall User Rating for providers who take Meritain Health. Our trusted partnership will afford you and your practice a healthy , Health WebContact us online Contact us by phone For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) Practice , Health WebMeritain Health Provider Credentialing Health (9 days ago) WebNetwork Participation and Credentialing Providers AmeriHealth Health (Just Now) WebAll providers , Health WebMeritain Health Provider Services Meritain Health. 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. Our trusted partnership will afford you and your practice a healthy Detail: Visit URL Category: Health View Health First, you can , https://www.health-improve.org/become-a-meritain-health-provider/, Health (4 days ago) WebOnline Certification Process Skip To Main Content Precertification Request Clinical Update Request Welcome to the Meritain Health benefits program. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. All rights reserved. PROVIDER RELATIONS APPLICABLE STATE Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 Richardson, TX 75085-3921 (87 Web MD/Emdeon, #41124 or McKesson/Relay Health 1761 (314) 644-4802 ext. Login - Meritain Aetna Claim Address|Aetna Provider Phone Number Updated (2023) December 23, 2022 by NSingh Aetna Provider Phone number and Aetna Claim address are updated from trusted and authorized online resources as per the latest updates. Login. Youll be joining a community of like-minded individuals, focused on wellness. This information is neither an offer of coverage nor medical advice. At Meritain Health, our goal is simpletake a creative approach to health care and build industry-leading connections. Your online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. 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). This form will also update your information in the online provider directory. Clinical Update Request. Reprinted with permission. Sutter Health is a registered Health (3 , Health WebWelcome to Meritain Health At Meritain Health, we create unrivaled connections. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Forgot Password? Thank you for your interest in joining our networks. Providers cannot request to alter or remove reviews. The following hospital and/or physician groups accept Meritain Health PPO. Meritain Health P.O. First, you can request participation in the Aetna network by completing our online request for participation form. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. CPT only Copyright 2022 American Medical Association. After review, Aetna will send your provider agreement via e-mail for signature. It is only a partial, general description of plan or program benefits and does not constitute a contract. **Please select one of the , Health (2 days ago) WebContact us. All rights reserved. When youre caring for a Meritain Health member, were glad to work with you to ensure they receive the very best. Copyright 2023 Meritain Health. Unlisted, unspecified and nonspecific codes should be avoided. Password. Applicable FARS/DFARS apply. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Credentialing involves collecting and , Health WebWelcome to Meritain Health's Aetna DocFind site. Providers should , Health (4 days ago) WebSee how you can join Meridian Health Plan's provider network quickly and easily online. Meritain Health - health insurance for employees - self-funding - TPA Please fill in all fields. Login 1000 MO IL KS Essence Healthcare Essence Healthcare Our trusted partnership will afford you and your practice a healthy dose of advantages. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. While we strive to keep this list up to date, it's always best to check with your health plan to determine the specific details of your coverage, including benefit designs and Sutter provider participation in your provider network. 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. When you visit the doctor, you may already be a little on edgewithout needing to worry about how your care will be covered! The Meritain Health YouTube channel includes lots of videos with more information about topics our members frequently ask about, and much more! If you have , https://qa.meritain.com/about-us-self-funded-employee-benefit-plans/meritain-health-provider-services/, Health (5 days ago) WebBecome A Meritain Health Provider Health (4 days ago) WebHealth Care Providers: Join the Aetna Network Health (5 days ago) WebHere's how it works: Step 1. I may or may not be employed by an Aetna-contracted provider. Health Plan Search Aetna - Meritain Health PPO - Sutter Health Past Week This site has been specially designed to provide quick and easy access to the Aetna provider directory. Our Customer Support team is just a phone call away for guidance on COVID-19 information, precertification and all your inquiries. An exception could be emergency care, when you might receive coverage at the in-network rate. Others have four tiers, three tiers or two tiers. 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. 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. 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. Phone number to dial 800-925-2272. Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health. Step 2. Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies, Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) While we strive to keep this list up to date, it's always best to check with your health plan to determine the specific details of your coverage, including benefit designs and Sutter provider participation in your provider network. 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). The information you will be accessing is provided by another organization or vendor. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. New and revised codes are added to the CPBs as they are updated. Youll benefit from our commitment to service excellence. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Aetna Claim Address|Aetna Provider Phone Number Updated (2023) Forgot Username? In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. This search will use the five-tier subtype. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. (6 days ago) WebTimely Filing Limit 2023 of all Major Insurances Health (4 days ago) WebThe timely filing limit varies by insurance company and typically ranges from 90 to 180 days. Username. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. And what if youre not sure how to find one? 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. All rights reserved | Email: [emailprotected], Meritain health check patient eligibility, Maryland licensed environmental health specialist, Mesa county health department grand junction, Behavioral health park nicollet st louis park.