2. CPT only copyright 2015 American Medical Association. 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). Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. Disclaimer of Warranties and Liabilities. For enhanced adults benefit, visit Dental Provider Search to view your dental providers. This Agreement will terminate upon notice if you violate its terms. . To help us direct your question or comment to the correct area, please select a category below. Aetna Better Health - LIBERTY Dental Plan 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). CPT only Copyright 2022 American Medical Association. This Agreement will terminate upon notice if you violate its terms. In case of a conflict between your plan documents and this information, the plan documents will govern. Do you want to continue? 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. 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. * Enter Provider ID : * Enter NPI : *Provider Type : Select a Provider Type Medical (Includes Behavioral Health) Dental Facilities. Plan highlights. Each plan has its own provider network. 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. 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. You also can look for more than 25 other types of health care providers, including pharmacies, marriage counselors, urgent care centers, acupuncturists, drug and alcohol counselors, hospice care providers, dialysis centers, vision care providers, flu shot providers and physical therapists. 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. 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. 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. 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. Learn about your health plan or find coverage for you and your family. Our find a dentist tool includes a brief survey to help us improve this service. Or they can help you find a provider. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. For language services, please call the number on your member ID card and request an operator. 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?. Geographic Search. 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. You can use the links below to find in-network providers and pharmacies nearyou. You are now being directed to CVS caremark site. This information is neither an offer of coverage nor medical advice. 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. 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. 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. 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. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The online provider directory is updateddaily. This information is neither an offer of coverage nor medical advice. The DSNP network is in limited counties. 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. Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. Click here to request an office transfer. All DSNP plans are required to have an approved Model of Care. To check that your provider participates, visit our website or call us. Find a Dentist. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Stay up-to-date with todays latest health care trends. Some subtypes have five tiers of coverage. 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.
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