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 that providers listed in this directory may perform services that are not covered by your health plan. Or they can help you find a provider. 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. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Health (3 days ago) Webfor a provider. 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). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. 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. YES - Prior authorization request is required for this service. . It is only a partial, general description of plan or program benefits and does not constitute a contract. The member's benefit plan determines coverage. To get started: 1. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. SELECT A DIRECTORY. Please enable it to continue. You can get dental care when you join Aetna Better Health of West Virginia. PA requirements are both Yes and No, as specified on the PA List. Links to various non-Aetna sites are provided for your convenience only. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The information you will be accessing is provided by another organization or vendor. 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). Need a new dental office home? 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. Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". You can also get the materials you need in a different language or format. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Your plan may only provide benefits if you obtain a referral from your General Dentist prior to receiving treatment from a Specialist. 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. You can use the links below to find in-network providers and pharmacies nearyou. 1367 Walter Reed Rd, 103, Fayetteville, NC 28304. Family planning, Emergent and Urgent Care services do not require PA. Reprinted with permission. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. You'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. Of course you can use our directories to find doctors and hospitals that take your insurance. Did you find information that you think may need to be updated in our provider directories? We encourage you to check with your participating provider prior to beginning treatment. You are now being directed to CVS Caremark site. Participating Providers: To determine if prior authorization (PA) is required, enter 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. 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. Please review the plan benefit coverage documentation under the link below. CPT is a registered trademark of the American Medical Association. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Access2Care performs transportation management services on behalf of Aetna Better Health. It is only a partial, general description of plan or program benefits and does not constitute a contract. The path to healthy starts here. 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. Street Address: City: State: County: Zip Code: Radius: . 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. You are now being directed to CVS caremark site. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. Aetnamedicare.blob.core.windows.net. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. All services deemed "never effective" are excluded from coverage. Links to various non-Aetna sites are provided for your convenience only. Members must choose a PCP* to guide their treatment and coordinate all specialist care which all takes place in a quality network to keep costs in check. NON-COV - CPT or HCPCS code entered is not a covered benefit by health plan. In case of a conflict between your plan documents and this information, the plan documents will govern. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. You can also get the materials you need in a different language or format. 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. 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. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. 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. General Dentists: provide all the services you need to maintain healthy teeth and gums. Aetna Better Health of Louisianais 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. 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). Each main plan type has more than one subtype. Links to various non-Aetna sites are provided for your convenience only. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. 2/22). You can get a copy of the provider directory by mail. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. The member's benefit plan determines coverage. Please correct the following errors and try again: Fill out this form to find providers and health care facilities near you. Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. CMS requires providers to take the Model of Care training course (PDF). New and revised codes are added to the CPBs as they are updated. We update our provider directory nightly. Prior Authorization may be required. To help us direct your question or comment to the correct area, please select a category below. Links to various non-Aetna sites are provided for your convenience only. This search will use the five-tier subtype. Do you want to continue? For children and other Medicaid members, dental providers are available through MCNA. Find your plan listed below and click Find a Dentist. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. Explore Medicaid benefits and added services. *Search by : Provider ID (PIN) NPI. Reprinted with permission. Links to various non-Aetna sites are provided for your convenience only. Search results are not a guarantee of claim payment. Applicable FARS/DFARS apply. Dental Savings Plans reduce the cost of dental care by 10%-60%, at thousands of participating dentists and dental specialists nationwide. Please be sure to add a 1 before your mobile number, ex: 19876543210. All rights reserved. Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. For language services, please call the number on your member ID card and request an operator. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Members should discuss any matters related to their coverage or condition with their treating provider. Links to various non-Aetna sites are provided for your convenience only. Request an Office Transfer. Find a Dentist. System (HCPCS) codes or a CPT group and select SEARCH. This information helps us provide information tailored to your Medicare eligibility, which is based on age. You can also get the materials you need in a different language or format.
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