Please contact Access2Care for benefit information by calling 1-866-252-5634 or visit www.Access2Care.net. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The provider network is subject to change. 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. 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. *Search by : Provider ID (PIN) NPI. . Visit our Medicare page for more DSNP resources, including cost-share 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. Enter your location by address, city or zip code. Exploration our provider manuals for find resources concerning Aetna policy guidelines that explain how to work with us. All provider information contained on this website is subject to change. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. The AMA is a third party beneficiary to this Agreement. 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. If you do not intend to leave our site, close this message. This list is updated nightly. General Dentists: provide all the services you need to maintain healthy teeth and gums. 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. 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. These directories of Louisianas network providers includes: Enter provider or facility name or select a specialty. Select a Plan * Select a Plan: 2. Plan highlights. 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 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. Please log in to your secure account to get what you need. Applicable FARS/DFARS apply. Members should show their DSNPmember ID cardand their state-issued Medicaid card. Contact Us - Health Care Providers - Aetna Explore Medicaid benefits and added services. . 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. Unlisted, unspecified and nonspecific codes should be avoided. 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. Aetna Provider Search - Small Business Benefits | Trustmark You can all Member Services at 1-866-638-1232, TTY PA Relay 7-1-1 , TTY 711, for help finding a provider. All Rights Reserved. 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. Health benefits and health insurance plans contain exclusions and limitations. Each main plan type has more than one subtype. *Required Selections. Aetna Better Health. #2020-93661 (exp. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). CPT is a registered trademark of the American Medical Association. Be sure to check your email for periodic updates. You will receive the discount off the providers usual and customary fees when you pay. Links to various non-Aetna sites are provided for your convenience only. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. 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 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. Please review the plan benefit coverage documentation under the link below. Join our network, and together, we'll give patients access to the highest quality, safest and most effective health care. Links to various non-Aetna sites are provided for your convenience only. Learn about your health plan or find coverage for you and your family. You are now being directed to the CVS Health site. The member's benefit plan determines coverage. New and revised codes are added to the CPBs as they are updated. To check that your provider participates, visit our website or call us. Category: Health Detail Health. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. Directory of Dentists Treating Members with Intellectual . 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 inpatient confinements require PA and usually ALL services provided . Treating providers are solely responsible for dental advice and treatment of members. Aetna international | International Medical Insurance 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. 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?. Depending on the members MSP eligibility, they may have a cost-share responsibility. Virginia State Dental Plans | Member Information - DentaQuest Find a Doctor :: State of Illinois - Aetna 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. 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). Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Please feel free tocontact us to provide any new information. NON-COV - CPT or HCPCS code entered is not a covered benefit by health plan. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. Address, phone number, and practice changes. CPT is a registered trademark of the American Medical Association. ProPAT CPT Code Lookup : Aetna Better Health Enter a zip code to search for dental care professionals in your area. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. 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. Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna Dentists Near Me. Aetna Inc. and itsitsaffiliated 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. Were a health care company thats building a healthier world. Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. All rights reserved | Email: [emailprotected], North country health care university flagstaff. Of course you can use our directories to find doctors and hospitals that take your insurance. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. 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. DocFind - Aetna Applicable FARS/DFARS apply. Applicable FARS/DFARS apply. Request an Office Transfer. Or they can help you find a provider. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Benefit coverage may vary by plan or may be subject to special conditions. 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. 2. 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). Health (3 days ago) Webfor a provider. You'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. 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. CPT only Copyright 2022 American Medical Association. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Some subtypes have five tiers of coverage. Treating providers are solely responsible for medical advice and treatment of members. The online provider directory is updateddaily. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. All services deemed "never effective" are excluded from coverage. 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. Need a new dental office home? ALL inpatient confinements require PA and usually ALL services provided by non-participating providers require PA. PA requirement results are valid as of todays date only. If your health benefit plan offers the Aetna Signature Administrators (ASA) PPO Network, use its online directory to search from approximately 1.4 million Aetna in-network providers and more than 6,000 hospitals nationwide. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Find a Provider | Aetna Medicaid 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. Aetna Better Health of Maryland Dental Provider Search. Aetna Inc. and itsitsaffiliated 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. 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. 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. Find a Provider. You can further filter the search results by adding a specific dentist . (Just Now) WebAetna Better Health dental coverage is a part of Aetna Better Health's overall health insurance plan. Best Aetna Pediatric Dentists Near Me | Zocdoc Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Note not all plans and offers available in all markets. A new version of our find a dentist tool is now available for Virginia members! Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. For enhanced adults benefit, visit Dental Provider Search to view your dental providers. You can get dental care when you join Aetna Better Health of West Virginia. 1367 Walter Reed Rd, 103, Fayetteville, NC 28304. Enter a zip code to search for dental care professionals in your area. Treating providers are solely responsible for medical advice and treatment of members. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. CPT only copyright 2015 American Medical Association. This search will use the five-tier subtype. Filter Type: All Symptom Treatment Nutrition Dental Services Aetna Medicaid New Jersey . Dental Savings Plans reduce the cost of dental care by 10%-60%, at thousands of participating dentists and dental specialists nationwide. 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. Provider manuals | Manuals | Aetna Better Health of Pennsylvania Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Find a Provider | Aetna Medicaid Illinois Enter Location . Stay up-to-date with todays latest health care trends. When billing, you must use the most appropriate code as of the effective date of the submission. 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. 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.