Filter Type: All Symptom Treatment Nutrition Dental Services Aetna Medicaid New Jersey . Log in to find doctors, dentists, hospitals and other providers that accept your plan. 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). Address, phone number, and practice changes. Links to various non-Aetna sites are provided for your convenience only. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. New and revised codes are added to the CPBs as they are updated. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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). Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Skip to main content . The ABA Medical Necessity Guidedoes not constitute medical advice. 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. Health benefits and health insurance plans contain exclusions and limitations. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Check your participation status using the provider search tool. Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. We update our provider directory nightly.You can get a copy of the provider directory by mail. Each main plan type has more than one subtype. 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 New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental 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. When making an appointment, please be sure your provider offers all services you may need, Avsis Incorporated and Avsis Third Party Administrators, Inc. (Avsis), are wholly owned subsidiaries of Guardian. Please be sure to add a 1 before your mobile number, ex: 19876543210. 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. You can use the links below to find in-network providers and pharmacies nearyou. logo Aethna Better Health of West Virginia. 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). The NJFC Directory of Dentists Treating Children under the Age of 6, Directory of Dentists Treating Members with Intellectual Disabilities Adult, Directory of Dentists Treating Members with Intellectual Disabilities Child, Directory of Dentists Treating NJFC in Long Term Care Facilities. This search will use the five-tier subtype. HMO Plan*; Open Access Plan; QCHP/CDHP Plan; For step-by-step instructions, click on a plan below. 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 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. You may also notify LIBERTY about provider directory updates by calling 888-703-6999. General Dentists: provide all the services you need to maintain healthy teeth and gums. *Required Selections. We welcome . For language services, please call the number on your member ID card and request an operator. Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. This search will use the five-tier subtype. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. EXPIRED - CPT or HCPCS code entered is no longer valid for use by health plan providers. When billing, you must use the most appropriate code as of the effective date of the submission. Were expanding our DSNP program into more markets for 2022. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 1. Members must select a primary care physician. VisitPharmacy Provider Search to view all your pharmacy providers. 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. If you have questions, visit our contact us page. Health. Find your plan listed below and click Find a Dentist. Medicaid. 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. 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. Use of any robot, spider or other intelligent agent to copy content from Provider Search, extract any portion of it or otherwise cause Provider Search to be burdened with unwarranted high access or transaction activity . Find a Dentist. The five character codes included in the Aetna Medicaid PA Requirement Search Tool are obtained from Current Procedural Terminology (CPT), by the American Medical Association (AMA).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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Health (9 days ago) WebProvider Search Find a Provider 1. Have an update for our Directory? The DSNP network is in limited counties. Let Customer Service know the providers you called. To reduce the Members should discuss any matters related to their coverage or condition with their treating provider. information regarding PA submission or service partner requirements. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Links to various non-Aetna sites are provided for your convenience only. Treating providers are solely responsible for dental advice and treatment of members. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. All Rights Reserved. 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. Reprinted with permission. 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. Or they can help you find a provider. WebAetna Better Health of Maryland Medicaid Dental Provider Search. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. 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. 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. Please consult with the respective plan detail page for additional plan terms. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Your plan may only provide benefits if you obtain a referral from your General Dentist prior to receiving treatment from a Specialist. LIBERTY makes certain language assistance services available to you at no cost. 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. . Request an Office Transfer. This Agreement will terminate upon notice if you violate its terms. The DSNP network is in limited counties. 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. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Pharmacy, dental or vision providers? The AMA is a third party beneficiary to this Agreement. 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. All Rights Reserved. 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. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. 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. Providers may not balance bill members who do not have cost-share responsibility (including QMB-only). This Agreement will terminate upon notice if you violate its terms. 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. 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 can call Aetna Better Health of Louisiana Member Services at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. Click here to request an office transfer. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. You'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . CPT only copyright 2015 American Medical Association. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Enter a zip code to search for dental care professionals in your area. Our find a dentist tool includes a brief survey to help us improve this service. 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. 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. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Click here to find an in-network vision provider thats close to you. Provider/Facility Name OR Specialty is required to continue, Please enter first and last name of Provider, or the name of the facility. Exception Detail, Svc Partner Detail - When the. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Disclaimer of Warranties and Liabilities. AetnaDentalOffers.com is brought to you by DentalPlans.com. This information is neither an offer of coverage nor medical advice. Applicable FARS/DFARS apply. Applicable FARS/DFARS apply. 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. 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. Aetna Better Health of Maryland Medicaid Dental Provider Search. Need a new dental office home? Please correct the following errors and try again: Fill out the form below to find providers and healthcare facilities near you. You can also get the materials you need in a different language or format. Prosthodontists: restore damaged teeth or replace missing ones, with procedures that include dental implants, bridges, crowns and dentures. The member's benefit plan determines coverage. Please contact Eviti Connect at. Note not all Aetna dental plans and offers available in all markets. 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. 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. CPT is a registered trademark of the American Medical Association. Request a medical application. 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. 2/22). Unlisted, unspecified and nonspecific codes should be avoided. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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 note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. For enhanced adults benefit, visit Dental Provider Search to view your dental providers. Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. In-network coverage only (except emergency . Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you do not intend to leave our site, close this message. Visit the secure website, available through www.aetna.com, for more information. Members should show their DSNPmember ID cardand their state-issued Medicaid card. We're sorry but Provider Locator doesn't work properly without JavaScript enabled. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Do you want to continue? Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. Health (3 days ago) Webfor a provider. CPT only Copyright 2022 American Medical Association. Links to various non-Aetna sites are provided for your convenience only. Experience and expertise to help our customers and members navigate the complex global health care landscape. Innovative benefits plans with options for medical, dental, vision, and pharmacy coverage. It is only a partial, general description of plan or program benefits and does not constitute a contract. Go to the American Medical Association Web site. VisitVision Provider Searchto view your vision providers. Tools and resources that create a more personalized and convenient . 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. Youll find these doctors with the label Quality Care, Effective , https://www.aetna.com/individuals-families/find-a-doctor.html, North country health care university flagstaff, Jps health network schedule appointments, Health care information system examples, 2021 health-improve.org. The information you will be accessing is provided by another organization or vendor. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. Each main plan type has more than one subtype. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. DocFind, Aetna's online participating provider directory, allows you to locate physicians and other health care providers such as dentists, optometrists, hospitals and pharmacies. No fee schedules, basic unit, relative values or related listings are included in CPT. Check your participation status using the provider search tool. Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . Thanks! If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page.
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