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. The member's benefit plan determines coverage. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Dr. Shannitta Bridgers is a pediatric dentist at Highland Pediatric Dental in Fayetteville, SC. You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. 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. Health. 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. 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. 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. 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. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. In case of a conflict between your plan documents and this information, the plan documents will govern. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Please be sure to add a 1 before your mobile number, ex: 19876543210. All DSNP plans are required to have an approved Model of Care. To get started: 1. Visit the secure website, available through www.aetna.com, for more information. Join our network, and together, we'll give patients access to the highest quality, safest and most effective health care. The information you will be accessing is provided by another organization or vendor. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan Innovative benefits plans with options for medical, dental, vision, and pharmacy coverage. 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). Members should show their DSNPmember ID cardand their state-issued Medicaid card. Prior Authorization may be required. Aetna Dentists Near Me. 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 or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. All Rights Reserved. CPT only Copyright 2022 American Medical Association. We update our provider directory nightly.You can get a copy of the provider directory by mail. 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. No fee schedules, basic unit, relative values or related listings are included in CPT. Links to various non-Aetna sites are provided for your convenience only. Links to various non-Aetna sites are provided for your convenience only. Members should discuss any matters related to their coverage or condition with their treating provider. Benefit coverage may vary by plan or may be subject to special conditions. 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 note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. We update our provider directory nightly. These directories of Louisianas network providers includes: Enter provider or facility name or select a specialty. 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. up to six Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding CPT is a registered trademark of the American Medical Association. Please log in to your secure account to get what you need. 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). Treating providers are solely responsible for medical advice and treatment of members. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Unlisted, unspecified and nonspecific codes should be avoided. New and revised codes are added to the CPBs as they are updated. This search will use the five-tier subtype. 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. 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. 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. You are now being directed to the CVS Health site. Helping you find the right doctor for you. 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. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. To see if your doctor is in our network, click a plan link below. Please review the plan benefit coverage documentation under the link below. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Category: Health Detail Health. Enter your location by address, city or zip code. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Skip to main content . The member's benefit plan determines coverage. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Learn about Aetna Smart Compare. Request a medical application. 2023 DentalPlans.com, Inc. All Rights Reserved. For language services, please call the number on your member ID card and request an operator. VisitVision Provider Searchto view your vision providers. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. The information you will be accessing is provided by another organization or vendor. Find the information and resources you need to meet your clients' needs. Exploration our provider manuals for find resources concerning Aetna policy guidelines that explain how to work with us. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Please enable it to continue. Treating providers are solely responsible for medical advice and treatment of members. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. 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. 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. Links to various non-Aetna sites are provided for your convenience only. Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. If you do not intend to leave our site, close this message. LIBERTY makes certain language assistance services available to you at no cost. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. Request an Office Transfer. YES - Prior authorization request is required for this service. The NJFC Directory of Dentists Treating Children under the Age of 6. ALL inpatient confinements require PA and usually ALL services provided . 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. The DSNP network is in limited counties. Click here to find an in-network vision provider thats close to you. CPT only copyright 2015 American Medical Association. You can further filter the search results by adding a specific dentist . Enter a zip code to search for dental care professionals in your area. Find a Provider. 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. This Agreement will terminate upon notice if you violate its terms. You start saving within 72 hours of joining a plan (no long waits before you qualify for discounted care!) Click here to let us know so we can fix it. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. 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). WebAetna Better Health of Maryland Medicaid Dental Provider Search. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The provider network is subject to change. Search results are not a guarantee of claim payment. 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. 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. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. 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. CPT is a registered trademark of the American Medical Association. Your benefits plan determines coverage. 2. Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. 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. Click here for additional information regarding benefit coverage.
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