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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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 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. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. If you are in New Jersey, check your status by going to the Aetna Assure Premier Plus provider search page. This search will use the five-tier subtype. You can also get the materials you need in a different language or format. 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. Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. You can get dental care when you join Aetna Better Health of West Virginia. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Applicable FARS/DFARS apply. 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. Reprinted with permission. 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. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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. Guardian is a registered trademark of The Guardian Life Insurance Company of America, New York, NY. 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. Street Address: City: State: County: Zip Code: Radius: . 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. Members should discuss any matters related to their coverage or condition with their treating provider. Request an Office Transfer. We're sorry but Provider Locator doesn't work properly without JavaScript enabled. This Agreement will terminate upon notice if you violate its terms. It provides coverage for a wide range of dental services, including . 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 information you will be accessing is provided by another organization or vendor. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. CPT is a registered trademark of the American Medical Association. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. 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). It is only a partial, general description of plan or program benefits and does not constitute a contract. 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 member's benefit plan determines coverage. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Join today and elevate your smile for less than you ever dreamed was possible. Treating providers are solely responsible for medical advice and treatment of members. 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. Others have four tiers, three tiers or two tiers. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Links to various non-Aetna sites are provided for your convenience only. We update our provider directory nightly.You can get a copy of the provider directory by mail. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. For language services, please call the number on your member ID card and request an operator. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 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 Dental Savings Plans are NOT dental insurance and the dental savings will vary by provider, plan and zip code. Note not all plans and offers available in all markets. 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. You are now being directed to CVS caremark site. Please correct the following errors and try again: Fill out the form below to find providers and healthcare facilities near you. Stay up-to-date with todays latest health care trends. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. You'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. 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. 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. Find the information and resources you need to meet your clients' needs. In-network coverage only (except emergency . This search will use the five-tier subtype. Providers may not balance bill members who do not have cost-share responsibility (including QMB-only). 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). Click here for additional information regarding benefit coverage. Treating providers are solely responsible for medical advice and treatment of members. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. For more details see our Privacy Policy. Click here to let us know so we can fix it. Medicaid. For children and other Medicaid members, dental providers are available through MCNA. Category: Health Detail Health. When billing, you must use the most appropriate code as of the effective date of the submission. Since there is no paperwork or reimbursement, you must pay for the service at the time its provided. 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. 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. Members should show their DSNPmember ID cardand their state-issued Medicaid card. In case of a conflict between your plan documents and this information, the plan documents will govern. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. You are now being directed to the CVS Health site. The AMA is a third party beneficiary to this Agreement. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. Plan highlights. . Search result definitions: NOTE: When selecting by CPT group, the results displayed include CPT codes where 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 . Or they can help you find a provider. All DSNP plans are required to have an approved Model of Care. Do you want to continue? Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If you are in Virginia, check your status by going to the Aetna Better Health of Virginia provider search page. The member's benefit plan determines coverage. Important information for Provider Search users who live in California , Colorado , Connecticut , Delaware , Florida . All services deemed "never effective" are excluded from coverage. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. 1367 Walter Reed Rd, 103, Fayetteville, NC 28304. 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. Of course you can use our directories to find doctors and hospitals that take your insurance. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. License to use 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. CPT only copyright 2015 American Medical Association. 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. This Agreement will terminate upon notice if you violate its terms. Please check before scheduling an appointment to make sure the provider is participating in the program. Treating providers are solely responsible for medical advice and treatment of members. The AMA is a third party beneficiary to this Agreement. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Please confirm with the provider when you call them. Health benefits and health insurance plans contain exclusions and limitations. 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). You are now being directed to the CVS Health site. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. 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 discuss any matters related to their coverage or condition with their treating provider. ", Provider/facility name OR specialty is required to continue. Directory of Dentists Treating Members with Intellectual . Aetnamedicare.blob.core.windows.net. 2023 DentalPlans.com, Inc. All Rights Reserved. Our directory PDF (or printed directory) is updated monthly.You can get a copy of the provider directory by mail. Filter Type: All Symptom Treatment Nutrition Dental Services Aetna Medicaid New Jersey . You can use the links below to find in-network providers and pharmacies nearyou. (Just Now) WebAetna Better Health dental coverage is a part of Aetna Better Health's overall health insurance 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. 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). Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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 all Member Services at 1-866-638-1232, TTY PA Relay 7-1-1 , TTY 711, for help finding a provider. 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. We welcome . 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. Please review the plan benefit coverage documentation under the link below. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Just call Member Services at 1-866-827-2710 (TTY: 711) to learn more about these services. Unlisted, unspecified and nonspecific codes should be avoided. 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. Access2Care performs transportation management services on behalf of Aetna Better Health. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. The dental discounts are available through participating healthcare providers only. For language services, please call the number on your member ID card and request an operator. 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. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Aetna offers health insurance, as well as dental, vision and other plans, to meet the needs of individuals and families, employers, health care providers and insurance agents/brokers. The HMO plan is ideal for employers in urban locations who want to offer simple, convenient care with fixed, predictable costs. System (HCPCS) codes or a CPT group and select SEARCH. Go to the American Medical Association Web site. Your benefits plan determines coverage. Each plan has its own provider network. 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. 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". symbol is displayed for the code, place your cursor over the symbol to review additional Treating providers are solely responsible for medical advice and treatment of members. Request a medical application. Unlisted, unspecified and nonspecific codes should be avoided. Members should discuss any matters related to their coverage or condition with their treating provider. When billing, you must use the most appropriate code as of the effective date of the submission. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. All Rights Reserved. Primary Care Providers, specialists, mental health providers, Qualified Family Planning Providers (QFFPs), dentists and vision care providers. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. 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. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. The DSNP network is in limited counties. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. To check that your provider participates, visit our website or call us. * Enter Provider ID : * Enter NPI : *Provider Type : Select a Provider Type Medical (Includes Behavioral Health) Dental Facilities. Please log in to your secure account to get what you need. Did you find information that you think may need to be updated in our provider directories? #2020-93661 (exp. 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 member's benefit plan determines coverage. Enter your location by address, city or zip code. Benefit coverage may vary by plan or may be subject to special conditions. Select a Plan * Select a Plan: 2. This information helps us provide information tailored to your Medicare eligibility, which is based on age. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. CPT is a registered trademark of the American Medical Association. 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.
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