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. 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). Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Search result definitions: NOTE: When selecting by CPT group, the results displayed include CPT codes where Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. Pharmacy, dental or vision providers? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Please consult with the respective plan detail page for additional plan terms. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. All Rights Reserved. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Aetna has one of the nation's largest dental networks, with more than 200,000 participating dental practices, making it easy to find a great dentist or specialist near you. Provider Search is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Please be sure to add a 1 before your mobile number, ex: 19876543210. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. SELECT A DIRECTORY. Treating providers are solely responsible for medical advice and treatment of members. 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. Aetna Better Health of Maryland Dental Provider Search. If you do not intend to leave our site, close this message. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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 . Join today and elevate your smile for less than you ever dreamed was possible. Were a health care company thats building a healthier world. Of course you can use our directories to find doctors and hospitals that take your insurance. Aetna Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. 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. 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 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. 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. 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. 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. You are now being directed to the CVS Health site. Stay up-to-date with todays latest health care trends. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. You can email your search results or print them. Go to the American Medical Association Web site. Skip to main content . Looking for a local dentist? 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. 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). Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. 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. #2020-93661 (exp. Request an Office Transfer. VisitVision Provider Searchto view your vision providers. 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. 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. * 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. Members should show their DSNPmember ID cardand their state-issued Medicaid card. Health (3 days ago) Webfor a provider. Click here to let us know so we can fix it. Dr. Shannitta Bridgers is a pediatric dentist at Highland Pediatric Dental in Fayetteville, SC. 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. Links to various non-Aetna sites are provided for your convenience only. Need a new dental office home? Members must reside in a county where Aetna Medicare offers a DSNP. Want to help transform health care? VisitPharmacy Provider Search to view all your pharmacy providers. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Enter your location by address, city or zip code. All Rights Reserved. Enter Location Details Zip Code: OR. 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. This Agreement will terminate upon notice if you violate its terms. The ABA Medical Necessity Guidedoes not constitute medical advice. We update our provider directory nightly. New and revised codes are added to the CPBs as they are updated. 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. Please log in to your secure account to get what you need. 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. System (HCPCS) codes or a CPT group and select SEARCH. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. A new version of our find a dentist tool is now available for Virginia members! You can further filter the search results by adding a specific dentist . Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. You can further filter the search results by adding a specific dentists name and/or the type of dental specialist you wish to see. Visit the secure website, available through www.aetna.com, for more information. 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). All Rights Reserved. Please enable it to continue. We're sorry but Provider Locator doesn't work properly without JavaScript enabled. *Search by : Provider ID (PIN) NPI. Exploration our provider manuals for find resources concerning Aetna policy guidelines that explain how to work with us. 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 NJFC Directory of Dentists Treating Children under the Age of 6, Directory of Dentists Treating Members with Intellectual Disabilities Adult, Directory of Dentists Treating Members with Intellectual Disabilities Child, Directory of Dentists Treating NJFC in Long Term Care Facilities. Did you find information that you think may need to be updated in our provider directories? The member's benefit plan determines coverage. Find the information and resources you need to meet your clients' needs. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. Please correct the following errors and try again: Fill out the form below to find providers and healthcare facilities near you. 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. You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Innovative benefits plans with options for medical, dental, vision, and pharmacy coverage. Oncology treatment plans must be submitted to NantHealth via their web portal, Eviti Connect, which will expedite clinical review of any chemotherapy, radiation therapy, or supportive medications that require prior-authorization. Please be sure to add a 1 before your mobile number, ex: 19876543210. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 2. 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. General Dentists: provide all the services you need to maintain healthy teeth and gums. For children and other Medicaid members, dental providers are available through MCNA. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. When billing, you must use the most appropriate code as of the effective date of the submission. CPT only Copyright 2022 American Medical Association. Directory of Dentists Treating Members with Intellectual . Health benefits and health insurance plans contain exclusions and limitations. 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). All services deemed "never effective" are excluded from coverage. Working with providers, our advanced care management techniques help increase quality, improve efficiency . The ABA Medical Necessity Guidedoes not constitute medical advice. Address, phone number, and practice changes. Medicaid your for low-income and working humans or families, their . Please confirm with the provider when you call them. Disclaimer of Warranties and Liabilities. and you keep saving there is no maximum annual spending limit! Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. Unlisted, unspecified and nonspecific codes should be avoided. 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. 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. For language services, please call the number on your member ID card and request an operator. Do you want to continue? In case of a conflict between your plan documents and this information, the plan documents will govern. logo Aethna Better Health of West Virginia. 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?. We welcome . CPT is a registered trademark of the American Medical Association. 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 are now being directed to the CVS Health site. 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). A DSNP is a special type of Aetna Medicare Advantage Prescription Drug (MAPD) plan. No fee schedules, basic unit, relative values or related listings are included in CPT. 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). Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. 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". You can also get the materials you need in a different language or format. WebAetna Better Health of Maryland Medicaid Dental Provider Search. 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). This Agreement will terminate upon notice if you violate its terms. Primary care physicians, specialists, mental health providers and family planning providers, Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Clinics, Adult day services, assisted living, home-delivered meals, home health agencies and home medical equipment providers. NJ FIDE-SNP members will have one member ID card for both Medicare and Medicaid. 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. Aetna Dentists Near Me. Provider/Facility Name OR Specialty is required to continue, Please enter first and last name of Provider, or the name of the facility. 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. Treating providers are solely responsible for medical advice and treatment of members. To check that your provider participates, visit our website or call us. Click here to find an in-network dental provider thats close to you. 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. ", Provider/facility name OR specialty is required to continue. CPT is a registered trademark of the American Medical Association. The provider network is subject to change. 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. It provides coverage for a wide range of dental services, including . These directories of Louisianas network providers includes: Enter provider or facility name or select a specialty. 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. 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 log in to your secure account to get what you need. Benefit coverage may vary by plan or may be subject to special conditions. Unlisted, unspecified and nonspecific codes should be avoided. 2/22). Learn more about our dental advantages. The AMA is a third party beneficiary to this Agreement. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. The NJFC Directory of Dentists Treating Children under the Age of 6. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. 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. Your benefits plan determines coverage. 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. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Choose from the largest directory of in-person & video visit providers in the nation. Applicable FARS/DFARS apply. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Louisiana, All Rights Reserved. Each plan has its own provider network. AetnaDentalOffers.com is brought to you by DentalPlans.com. Links to various non-Aetna sites are provided for your convenience only. Hospitals, long-term care facilities and skilled nursing facilities for rehabilitation, mental health facilities, Federally Qualified Health Centers and Rural Health Centers. Applicable FARS/DFARS apply. Please contact Eviti Connect at. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Use of any robot, spider or other intelligent agent to copy content from Provider Search, extract any portion of it or otherwise cause Provider Search to be burdened with unwarranted high access or transaction activity . The dental discounts are available through participating healthcare providers only. Learn about your health plan or find coverage for you and your family. No fee schedules, basic unit, relative values or related listings are included in CPT. You will receive the discount off the providers usual and customary fees when you pay. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Please check before scheduling an appointment to make sure the provider is participating in the program. Find a Dentist. LIBERTY makes certain language assistance services available to you at no cost. Aetna Inc. and itsitsaffiliated 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. Check your participation status using the provider search tool. For language services, please call the number on your member ID card and request an operator. (Just Now) WebAetna Better Health dental coverage is a part of Aetna Better Health's overall health insurance plan. To see if your doctor is in our network, click a plan link below. Log in to find doctors, dentists, hospitals and other providers that accept your plan. 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". 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. Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. CPT is a registered trademark of the American Medical Association. 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. Aetna Better Health. You can get a copy of the provider directory by mail. Please review the plan benefit coverage documentation under the link below. 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. Youd likely go to an oral surgeon if you have an impacted wisdom tooth or need another type of other complicated extraction. Please feel free tocontact us to provide any new information. By providing us with your email address, you agree to receive email communications from Aetna until you opt out of further emails. 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. 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. If you do not intend to leave our site, close this message. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. Directory of Dentists Treating Members with Intellectual Disabilities Adult. 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. Applicable FARS/DFARS apply. Your Plan: Your Plan: Aetna Medicaid collaborates with providers to deliver care that meets cost and quality goals. Click here to find an in-network pharmacy provider thats close to you. Note not all plans and offers available in all markets. Click here to find an in-network vision provider thats close to you. If you do not intend to leave our site, close this message.