Please correct the following errors and try again: Fill out this form to find providers and health care facilities near you. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. All provider information contained on this website is 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. Looking for a local dentist? The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Aetnamedicare.blob.core.windows.net. Tools and resources that create a more personalized and convenient . ", Provider/facility name OR specialty is required to continue. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Each main plan type has more than one subtype. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. AetnaDentalOffers.com is brought to you by DentalPlans.com. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Working with providers, our advanced care management techniques help increase quality, improve efficiency . 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. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 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 FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Of course you can use our directories to find doctors and hospitals that take your insurance. 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). Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Links to various non-Aetna sites are provided for your convenience only. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Unrivaled access to care in 200+ countries and territories around the world. Provider site; Please america; Search. 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. 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. Applicable FARS/DFARS apply. Aetna Medicaid collaborates with providers to deliver care that meets cost and quality goals. Address, phone number, and practice changes. For children and other Medicaid members, dental providers are available through MCNA. You can also get the materials you need in a different language or format. Dr. Shannitta Bridgers is a pediatric dentist at Highland Pediatric Dental in Fayetteville, SC. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Directory of Dentists Treating Members with Intellectual . 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 Better Health of Illinois is not responsible or liable for non-Aetna Better Health content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. CPT only copyright 2015 American Medical Association. Pharmacy prior auth phone number: 1-855-221-5656. 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. 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. This search will use the five-tier subtype. 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). The information you will be accessing is provided by another organization or vendor. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. If you do not intend to leave our site, close this message. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. Please confirm with the provider when you call them. Aetna Inc. and its subsidiary 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. Select a Plan * Select a Plan: 2. Aetna better health florida healthy kids. Aetna Dentists Near Me. Check your participation status using the provider search tool. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. 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. Disclaimer of Warranties and Liabilities. No fee schedules, basic unit, relative values or related listings are included in CPT. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. 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 are now being directed to CVS caremark site. Of course you can use our directories to find doctors and hospitals that take your insurance. Benefit coverage may vary by plan or may be subject to special conditions. 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. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Treating providers are solely responsible for dental advice and treatment of members. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. What's covered? Join today and elevate your smile for less than you ever dreamed was possible. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Medicaid your for low-income and working humans or families, their . Aetna Better Health. Others have four tiers, three tiers or two tiers. This information helps us provide information tailored to your Medicare eligibility, which is based on age. You are now being directed to CVS Caremark site. Unlisted, unspecified and nonspecific codes should be avoided. Join our team. As a LIBERTY enrollee (including enrollees with disabilities), you have full and equal access to covered services as required under the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973. Join our network, and together, we'll give patients access to the highest quality, safest and most effective health care. 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. To help us direct your question or comment to the correct area, please select a category below. Aetna Better Health of Maryland Dental Provider Search. Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. Treating providers are solely responsible for medical advice and treatment of members. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Please contact Access2Care for benefit information by calling 1-866-252-5634 or visit www.Access2Care.net. Thanks! and you keep saving there is no maximum annual spending limit! New and revised codes are added to the CPBs as they are updated. If English is not your preferred language and you need help communicating in your preferred language, you may call 888-703-6999 to ask what language services are available to you. Geographic Search. Prior Authorization may be required. 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). To reduce the CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. All Rights Reserved. Request a medical application. Enter Location Periodontists: these dentists specialize in treating complex cases of gum disease, along with other infections or problems involving the tissues that support the teeth. Unlisted, unspecified and nonspecific codes should be avoided. 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. YES - Prior authorization request is required for this service. Street Address: . Click here to let us know so we can fix it. If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health Provider Relations at 1-855-364-0974. The information you will be accessing is provided by another organization or vendor. 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. Just scroll down to "Find local care. Depending on the members MSP eligibility, they may have a cost-share responsibility. 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. By clicking on I accept, I acknowledge and accept that: Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Do you want to continue? Select a Plan * Select a Plan: 2. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. All services deemed "never effective" are excluded from coverage. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Enter your location by address, city or zip code. This Agreement will terminate upon notice if you violate its terms. DocFind, Aetna's online participating provider directory, allows you to locate physicians and other health care providers such as dentists, optometrists, hospitals and pharmacies. Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. You can get a copy of the provider directory by mail. 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. Were expanding our DSNP program into more markets for 2022. 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). Members must reside in a county where Aetna Medicare offers a DSNP. 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). 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. You are now being directed to CVS Caremark site. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan 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. You are now being directed to the CVS Health site. In case of a conflict between your plan documents and this information, the plan documents will govern. If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health Provider Relations at 1-855-364-0974. Provider Directory Aetna Better Health of Pennsylvania. Please review the plan benefit coverage documentation under the link below. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 2023 LIBERTY Dental Plan, All Rights Reserved. This information is neither an offer of coverage nor medical advice. Links to various non-Aetna sites are provided for your convenience only. Links to various non-Aetna sites are provided for your convenience only. This list is updated nightly. There is no obligation to enroll. Find your plan listed below and click Find a Dentist. Have an update for our Directory? You may also notify LIBERTY about provider directory updates by calling 888-703-6999. Each plan has its own provider network. 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. 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. The member's benefit plan determines coverage. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Others have four tiers, three tiers or two tiers. Reprinted with permission. 2022 Dual Eligible Special Needs Plans (DSNPs) information, Required Centers for Medicare & Medicaid Services (CMS) training, Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, OfficeLink Updates Newsletters Medicare Updates, Aetna Better Health of Virginia provider search page, Aetna Assure Premier Plus provider search page. Links to various non-Aetna sites are provided for your convenience only. Your Plan: Your Plan: If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. You are now being directed to the CVS Health site. This search will use the five-tier subtype. Please log in to your secure account to get what you need. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. 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. New and revised codes are added to the CPBs as they are updated. 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. Health benefits and health insurance plans contain exclusions and limitations. Find the information and resources you need to meet your clients' needs. We welcome . 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. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. 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. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Treating providers are solely responsible for medical advice and treatment of members. Check your participation status using the provider search tool. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. System (HCPCS) codes or a CPT group and select SEARCH. 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. 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. 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. 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. 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 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. 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. 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. Please log in to your secure account to get what you need. Listing Websites about Aetna Better Health Dental Provider. Enter your location by address, city or zip code. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. You can also get the materials you need in a different language or format. The online provider directory is updateddaily. For language services, please call the number on your member ID card and request an operator. 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 information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Members should discuss any matters related to their coverage or condition with their treating provider. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. CPT only copyright 2015 American Medical Association. 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. From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. 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. You start saving within 72 hours of joining a plan (no long waits before you qualify for discounted care!) Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Do you want to continue? Find a Dentist. CPT is a registered trademark of the American Medical Association. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Louisiana, All Rights Reserved. For more details see our Privacy Policy. Disclaimer of Warranties and Liabilities. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. EXPIRED - CPT or HCPCS code entered is no longer valid for use by health plan providers. Provider Directory. Medicaid. Health (3 days ago) Webfor a provider. Category: Health Detail Health. Treating providers are solely responsible for medical advice and treatment of members. 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. Links to various non-Aetna sites are provided for your convenience only. 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. Learn more about our dental advantages. Members should discuss any matters related to their coverage or condition with their treating provider. Innovative benefits plans with options for medical, dental, vision, and pharmacy coverage. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. WebAetna Better Health of Maryland Medicaid Dental Provider Search. Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . Please log in to your secure account to get what you need. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. You will receive the discount off the providers usual and customary fees when you pay. Members should always contact the provider's office in advance to confirm availability. 1999- 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. Explore Medicaid benefits and added services. The member's benefit plan determines coverage.
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