This Agreement will terminate upon notice if you violate its terms. We're sorry but Provider Locator doesn't work properly without JavaScript enabled. Directory of Dentists Treating Members with Intellectual Disabilities Adult. 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). DocFind, Aetna's online participating provider directory, allows you to locate physicians and other health care providers such as dentists, optometrists, hospitals and pharmacies. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Aetna international | International Medical Insurance 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. It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. This information is neither an offer of coverage nor medical advice. No fee schedules, basic unit, relative values or related listings are included in CPT. If you have questions, visit our contact us page. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Best Aetna Pediatric Dentists Near Me | Zocdoc For Use by Doctors and Facilities only. Aetna Better Health of Maryland Dental Provider Search - Avesis 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 AMA is a third party beneficiary to this Agreement. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . We update our provider directory nightly.You can get a copy of the provider directory by mail. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Members must reside in a county where Aetna Medicare offers a DSNP. 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. Providers may not balance bill members who do not have cost-share responsibility (including QMB-only). The dental discounts are available through participating healthcare providers only. Just scroll down to "Find local care. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. 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. 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. 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. Applicable FARS/DFARS apply. 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. 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). Find a Provider | Aetna Medicaid The member's benefit plan determines coverage. 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. 2020 Avsis Incorporated. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Street Address: . Enter a zip code to search for dental care professionals in your area. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. CPT only Copyright 2022 American Medical Association. 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. DocFind - Aetna Pharmacy, dental or vision providers? For language services, please call the number on your member ID card and request an operator. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan Go to the American Medical Association Web site. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. 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?. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. HMO | Aetna Health Plans 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. Request an Office Transfer. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. You can email your search results or print them. Please review the plan benefit coverage documentation under the link below. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. Go to the American Medical Association Web site. The information you will be accessing is provided by another organization or vendor. You are now being directed to the CVS Health site. 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. Applicable FARS/DFARS apply. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Aetna dental plans are not considered to be qualified health plans under the Affordable Care Act. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Or they can help you find a provider. 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. CPT only copyright 2015 American Medical Association. This list is updated nightly. symbol is displayed for the code, place your cursor over the symbol to review additional It is only a partial, general description of plan or program benefits and does not constitute a contract. New and revised codes are added to the CPBs as they are updated. The ABA Medical Necessity Guidedoes not constitute medical advice. Members must select a primary care physician. Disclaimer of Warranties and Liabilities. To help us direct your question or comment to the correct area, please select a category below. Find a Dentist. You start saving within 72 hours of joining a plan (no long waits before you qualify for discounted care!) 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. Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. All Rights Reserved. The ABA Medical Necessity Guidedoes not constitute medical advice. Find a Dentist. 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). Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. You'll find these doctors with the label "Quality Care," "Effective Care" or both in your 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. Dentists and dental office professionals, log in to Aetna Dental to handle claims, find forms, stay ahead of policy changes and more. Dental Providers: Register now for AetnaDental.com Medical Providers: Register for Aetna's Provider portal on Availity: New and revised codes are added to the CPBs as they are updated. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. https://www.bing.com/aclk?ld=e8pp1GAj_I-V3BVCYY9CDy-DVUCUwNn4b_zBqwYEAyr-b5hM7-uljdETFqFUDVn1verRx1HD9OEM8mlH0-4MuIitnhUOrSe-AsgxSUMwda7uvhTkMRqFaU9WzQiCY7N9Y6uEORiZbZ_yLxe-Ad0825VJyGWU7_QhyLDFQc1zv459ATOOp7YUal1ilBxK3MVXkJOzx6Og&u=aHR0cHMlM2ElMmYlMmZib29rLnpvY2RvYy5jb20lMmZnZXQtc3RhcnRlZCUyZmRlbnRpc3RzJTNmdXRtX3NvdXJjZSUzZGJpbmclMjZ1dG1fbWVkaXVtJTNkY3BjX2dlbmVyaWMlMjZ1dG1fY2FtcGFpZ24lM2Q0MDEyMTU1NTIlMjZ1dG1fdGVybSUzZCUyNTJCYWV0bmElMjUyMCUyNTJCZGVudGlzdCUyNnV0bV9jb250ZW50JTNkMTIzMzY1MjI2MTQ5NDAyNCUyNm1zY2xraWQlM2RlZTJhMzY3ZTU4YjMxZjhjNTcyZjUyMmU0YzlkOTgzMQ&rlid=ee2a367e58b31f8c572f522e4c9d9831, Health (2 days ago) WebEvery member with an Aetna Assure Premier Plus (HMO D-SNP) plan gets access to this dental benefit, including members who qualify for: Fully Integrated Dual-Eligible Special Needs Plan (FI D-SNP) Our members , https://www.aetnabetterhealth.com/new-jersey-hmosnp/providers/dental-services.html, Health (8 days ago) WebDental Savings Plans reduce the cost of dental care by 10%-60%, at thousands of participating dentists and dental specialists nationwide. Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. Meritain Health's Aetna DocFind site Dental Benefits | Aetna Medicaid West Virginia / Dental Benefits