Aetna Better Health of Maryland Dental Provider Search. 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. Provider Directory Aetna Better Health of Pennsylvania. 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, the Federal government or CMS for Medicare and Medicaid members. 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. A new version of our find a dentist tool is now available for Illinois members! It provides coverage for a wide range of dental services, including . If you do not intend to leave our site, close this message. Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. Participating Providers: To determine if prior authorization (PA) is required, enter Links to various non-Aetna sites are provided for your convenience only. 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. 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. Family planning, Emergent and Urgent Care services do not require PA. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. You can also get the materials you need in a different language or format. You can further filter the search results by adding a specific dentist . Search result definitions: NOTE: When selecting by CPT group, the results displayed include CPT codes where 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. 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. Your Plan: Your Plan: 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. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna 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. 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. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . CPT is a registered trademark of the American Medical Association. 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. Enter your location by address, city or zip code. You can also get the materials you need in a different language or format. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. To get started: 1. 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. Find a Dentist. Learn about your health plan or find coverage for you and your family. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Applicable FARS/DFARS apply. Disclaimer of Warranties and Liabilities. 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. Links to various non-Aetna sites are provided for your convenience only. information regarding PA submission or service partner requirements. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Do you want to continue? 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). Of course you can use our directories to find doctors and hospitals that take your insurance. For non-participating health care professionals. To help us direct your question or comment to the correct area, please select a category below. In case of a conflict between your plan documents and this information, the plan documents will govern. Aetna Medicaid collaborates with providers to deliver care that meets cost and quality goals. This information helps us provide information tailored to your Medicare eligibility, which is based on age. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. 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. Stay up-to-date with todays latest health care trends. The NJFC Directory of Dentists Treating Children under the Age of 6. Visit the secure website, available through www.aetna.com, for more information. Were a health care company thats building a healthier world. Just call Member Services at 1-866-329-4701 (TTY: 711) to learn more about these services. 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. Links to various non-Aetna sites are provided for your convenience only. 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). From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. These directories of Louisianas network providers includes: Enter provider or facility name or select a specialty. It is only a partial, general description of plan or program benefits and does not constitute a contract. You can further filter the search results by adding a specific dentists name and/or the type of dental specialist you wish to see. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. The AMA is a third party beneficiary to this Agreement. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna better health florida healthy kids. 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. logo Aethna Better Health of West Virginia. Please check before scheduling an appointment to make sure the provider is participating in the program. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna Better Health 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 . You can email your search results or print them. Exploration our provider manuals for find resources concerning Aetna policy guidelines that explain how to work with us. Links to various non-Aetna sites are provided for your convenience only. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. 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. Check your participation status using the provider search tool. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. No fee schedules, basic unit, relative values or related listings are included in CPT. Helping you find the right doctor for you. The HMO plan is ideal for employers in urban locations who want to offer simple, convenient care with fixed, predictable costs. 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. Pharmacy prior auth phone number: 1-855-221-5656. Aetna Dentists Near Me. 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. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. 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). Please refer to your Summary Plan Description (SPD) for an outline of your plan's covered benefits . WebAetna Better Health of Maryland Medicaid Dental Provider Search. New and revised codes are added to the CPBs as they are updated. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Check your participation status using the provider search tool. Dental Providers: Register now for AetnaDental.com Medical Providers: Register for Aetna's Provider portal on Availity: Members should show their DSNPmember ID cardand their state-issued Medicaid card. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. 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. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. To see if your doctor is in our network, click a plan link below. . Let Customer Service know the providers you called. All DSNP plans are required to have an approved Model of Care. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. Click here to let us know so we can fix it. 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". The provider network is subject to change. If services are not covered by the Medicare plan, Aetna Better Health of Ohio may cover these services. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Aetnamedicare.blob.core.windows.net. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. You'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". For Use by Doctors and Facilities only. This search will use the five-tier subtype. 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. 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. You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . 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. EXPIRED - CPT or HCPCS code entered is no longer valid for use by health plan providers. 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. * Enter Provider ID : * Enter NPI : *Provider Type : Select a Provider Type Medical (Includes Behavioral Health) Dental Facilities. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. CPT is a registered trademark of the American Medical Association. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. Learn about Aetna Smart Compare. 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. Listing Websites about Aetna Better Health Dental Provider. This Agreement will terminate upon notice if you violate its terms. Besides treating dental conditions, she educates her young patients on the importance of proper dental health and dispenses practical advice on maintaining dental hygiene. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Need a new dental office home? 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. Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. 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. 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. Links to various non-Aetna sites are provided for your convenience only. You are now being directed to CVS caremark site. We work with physicians to develop common platforms and goals, shifting the focus from episodes of care to making patient populations healthier. Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. If your patient has primary Medicare coverage outside of Aetna Better Health Premier Plan, please call the Medicare plan for benefits and authorization requirements. The AMA is a third party beneficiary to this Agreement. For language services, please call the number on your member ID card and request an operator. System (HCPCS) codes or a CPT group and select SEARCH. AetnaDentalOffers.com is brought to you by DentalPlans.com. A new version of our find a dentist tool is now available for Virginia members! Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Click here for additional information regarding benefit coverage. 1. Or they can help you find a provider. 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. Treating providers are solely responsible for dental advice and treatment of members. YES - Prior authorization request is required for this service. Directory of Dentists Treating Members with Intellectual . Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Health (3 days ago) Webfor a provider. The path to healthy starts here. 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. . Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Or they can help you find a provider. Find your plan listed below and click Find a Dentist. Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination. For more details see our Privacy Policy. Applicable FARS/DFARS apply. 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. This search will use the five-tier subtype. All rights reserved. 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. #2020 . Members must select a primary care physician. Medicaid your for low-income and working humans or families, their . Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. Please note that providers listed in this directory may perform services that are not covered by your health plan. 2023 DentalPlans.com, Inc. All Rights Reserved. LIBERTY makes certain language assistance services available to you at no cost. Please log in to your secure account to get what you need. There is no obligation to enroll. Please log in to your secure account to get what you need. *Search by : Provider ID (PIN) NPI. If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. Were expanding our DSNP program into more markets for 2022. 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. 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. If you are looking for a specific provider and cannot find them online, need more information,help, or would like a printed copy of the provider directory mailed to you,callus at 1-855-242-0802, TTY 711, 24 hours a day, 7 days a week. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Treating providers are solely responsible for dental advice and treatment of members. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Enter Location This information is neither an offer of coverage nor medical advice. For enhanced adults benefit, visit Dental Provider Search to view your dental providers. ", Provider/facility name OR specialty is required to continue. 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. 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. You are now being directed to CVS Caremark site. The DSNP network is in limited counties. All Rights Reserved. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating 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. Health. For language services, please call the number on your member ID card and request an operator. 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. Pharmacy, dental or vision providers? While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Learn more about our dental advantages. Plan from an employer Aetna Medicare plan, Individual health plan Aetna Medicaid plan Geographic Search. Click here to find an in-network pharmacy provider thats close to you. Innovative benefits plans with options for medical, dental, vision, and pharmacy coverage. No fee schedules, basic unit, relative values or related listings are included in CPT.
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