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. HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11842 Rx Group: NC Tax ID: 94-1340523 COB Address P.O. For others, request to use the Aetna logo. back to FAQ listWhere can I find my Member ID number? INSURANCE. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. Check the back of your card first, as it is not usually on the front! In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. You may get a discount if you use a NAP doctor. Treating providers are solely responsible for medical advice and treatment of members. Find your Member ID on your ID card, Welcome Letter, or any EOB you received from us. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. This information is neither an offer of coverage nor medical advice. Using the Aetna Navigator, you may obtain your digital card. You might look at your Medicare card and wonder This Agreement will terminate upon notice if you violate its terms. Gross Point of Rating. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. The information you will be accessing is provided by another organization or vendor. All services deemed "never effective" are excluded from coverage. 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. The AMA is a third party beneficiary to this Agreement. Insurance company contact information Links to various non-Aetna sites are provided for your convenience only. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Your health insurance policy number is typically your member ID number. How long does it take to get an insurance check from a car accident with a lawyer? WebThe member can activate their card by calling the number on their activation sticker. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. 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. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Total Benefit Solutions (Aetna International), Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871, Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871, Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Disclaimer of Warranties and Liabilities. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. It usually only appears on insurance cards that registered employers provided. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). Not all insurance cards have a group plan number. For example, on CDPHP ID cards, the group number is located on 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. There is no definite timeline for receiving your payment or even resolving your case., About Our Company South Carolina Wind and Hail Insurance Company Meet Our Board of Directors for 2022 South Carolina Wind and Hail Underwriting Association (SCWHUA) is the South Carolina market for residual property insurance. Check the back of your card first, as it is not usually on the front! Where Is the Aetna Insurance Card Policy Number? Health benefits and health insurance plans contain exclusions and limitations. The best place to find details about your coverage and benefits is your secure member website. If your insurance company simply mailed you a medical insurance card, you may often get information about your pharmacy coverage online or by phoning your insurance company (look for the phone number for Member Services on the back of your card). Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. USA. Lets say your health insurance plans allowed amount for an office visit is $100 and your coinsurance is 20%. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. However, a discount cannot be guaranteed under the NAP for any particular claim. 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. How to report a disability insurance company for bad faith? While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. If its not there, you may need to call the customer service number, but you also just might not have one if youre not receiving your coverage through your employer. Whats the subscriber name on an insurance card? The member's benefit plan determines coverage. 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). CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. Example: W123456789. They do not have access to member accounts but they can provide Aetna Member Services contact information. 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 member's benefit plan determines coverage. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. Enter your member ID without spaces or dashes. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. The policy number is usually located on the front of the card, near the top. The Aetna Choice POS II Plan is a network plan that gives you the freedom to select any licensed provider when you need care. Your benefits plan determines coverage. 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. If you purchased your insurance through the health exchange you might not have a group number. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. How Long Does It Take to Receive a Check for a Car Accident Settlement? Aetna Inc. and its subsidiary 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. Need extra assistance? What is my Aetna ID number? Our phone service can help with: Answering eligibility and benefits coverage questions. Enter your member ID without spaces or dashes. 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. Copyright 2015 by the American Society of Addiction Medicine. What is my Aetna ID number? This is also called your Subscriber ID number, and you can find it on your Health Net insurance card. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. WebYou can find your member ID number on your member ID card. This number is always displayed on the cards front. How much is health insurance a month for a single person? You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. CPT is a registered trademark of the American Medical Association. A subscriber ID is an alphanumeric identification for a particular subscriber in your database. Need help finding your Member ID? If you just have a medical insurance card and you need information about your pharmacy coverage, you can contact your insurance company. Each main plan type has more than one subtype. 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. The policy number is usually located on the front of the card, near the top. Types of Health Insurance Cards. Employers can also locate the company's group number on You might look at your Medicare card and wonder To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. When billing, you must use the most appropriate code as of the effective date of the submission. Unlisted, unspecified and nonspecific codes should be avoided. It is only a partial, general description of plan or program benefits and does not constitute a contract. CPT only Copyright 2022 American Medical Association. 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. All Rights Reserved. For general inquiries, reach our corporate headquarters at 1-888-US-AETNA (1-800-872-3862) (TTY: 711). Example: W123456789. How to start a insurance broker business? Is the digital Aetna ID card same to the physical card? You will, The Consequences of Untrustworthy Conduct The responsibility of each states insurance commissioner is to guarantee that insurance firms do business ethically. The expense might not These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. Do you want to continue? Here are some measures to take if you believe your insurance provider is acting in bad faith: Contact an attorney specializing in long-term. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. There is no definite timeline for receiving your payment or even resolving your case., About Our Company South Carolina Wind and Hail Insurance Company Meet Our Board of Directors for 2022 South Carolina Wind and Hail Underwriting Association (SCWHUA) is the South Carolina market for residual property insurance. 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. While ID cards vary according to the health plan that designs them, the group number is a vital piece of information that should be included. It offers coverage for wind and hail in the legislatively defined, Independent Agents are fully unaffiliated with a parent firm. 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. Each employer that buys a health plan for its employees also has a number. If you have an account with Twentyeight Health, you may contact our customer service team at [emailprotected] health or by texting us at (929) 352-0050. During regular business hours, you can ask to speak with a member services representative. There is no option for members to get information at this number. The majority of pharmacy cards will have all four numbers (Member ID, RxGroup, RxPCN, and RxBIN), although there are a few plans that do not include all four digits but are still approved. Check the back of your card first, as it is not usually on the front! What is subscriber number on insurance card Aetna? Visit the secure website, available through www.aetna.com, for more information. New and revised codes are added to the CPBs as they are updated. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Our official Aetna customer service Twitter representatives are here to help, listen and learn from you. Employers can also locate the company's group number on Insurers have reported several issues with the firm, including denial of benefits and payment delays. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. When billing, you must use the most appropriate code as of the effective date of the submission. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Medical card example: To process a prescription for medicine, pharmacies often require a pharmacy benefits card, which has a RxGroup, RxPCN, and RxBIN number in addition to the Member ID number. You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. CPT only Copyright 2022 American Medical Association. Join us in a conversation about the future of healthcare. WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. How to report a disability insurance company for bad faith? Your subscriber ID number is an ID number assigned by your employer or Delta Dental. You use it when you visit the doctor, hospital or other provider. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The AMA is a third party beneficiary to this Agreement. Your benefits plan determines coverage. The number is always on the front of the card. That number is 1-877-261-9951 (TTY:711) . Always provide your Member ID Card while visiting a medical institution or doctor. Aetna Inc. If you only have Original Medicare, you dont have a group number, but your 11-digit Medicare number is on your red, white and blue Medicare card. Please be sure to add a 1 before your mobile number, ex: 19876543210. Everyone covered by your companys insurance will have the same group number. What is the GRP acronym? What policy number is shown on an Aetna insurance card? The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. What is the insurance number on a card issued by Aetna Insurance? This plan offers both in-network and out-of-network benefits; however, the plans reimbursement is higher when you use an in-network provider. You can still get benefits and coverage information by calling the number on your ID card. Webcheck the H&PBP numbers on the bottom right of the ID card. Member ID/Policy Number. Both your group number and your member ID number will be located on your physical ID card and your mobile ID card, which is available on your SimplyInsured dashboard. 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. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. Not all insurance cards have a group plan number. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Understanding your card can help you plan your healthcare expenses and get the care you need. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Is my policy number my account number? Is my insurance policy number the same as my ID number? If you cant find your insurance card, dont Preview / Show more . Click on View Member ID, on the left side of page under family/plans. What is the GRP acronym? For your convenience, we recommend that you add your Member Services number to your phone contacts. If you are the policyholder, the last two digits in your number might be 00, while others on the policy might have numbers ending with numeric characters like 01,02, etc. 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. It is only a partial, general description of plan or program benefits and does not constitute a contract. How does south carolina cover wind and hail insurance? Webnumber is listed on the back of your Aetna ID card. The member's benefit plan determines coverage. RxBIN is an acronym for Bank Identification Number, which assists pharmacies in determining which insurance companys prescription plan to process. Aetna Inc. 151 Farmington Avenue. Employers can also locate the company's group number on Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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. This leads in the subsequent advantages: Freedom from onerous parent company requirements Permission to cross-sell other types of insurance Capability to compare insurers on pricing, product, and service. How to report a disability insurance company for bad faith. Member ID/Policy Number. WebYour full legal name as it appears on your Medicare ID card; Your Social Security number (even if you receive benefits through your spouse) Your address and contact info, including your phone number or email address; You may also be Insurance company contact information What does GRP mean on an Aetna card? If you cant find your insurance card, dont Preview / Show more . It is doubtful that your group health insurance number will appear on the back of your card, as the cards front contains all of the most significant information. Some subtypes have five tiers of coverage. Aetna Insurance Member Id from aestheticname.blogspot.com. This number is always displayed on the cards front. These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. Your Medicare group number should be on your insurance card for your Medicare Advantage, Medicare Supplement or Part D plan. 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. An automated telephone system will answer your call. The ABA Medical Necessity Guidedoes not constitute medical advice. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. In seconds, it will get you to the right person to help you. Where can I locate my Medicare group number? The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you do not intend to leave our site, close this message. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Your health insurance ID card is your proof of insurance. 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. Need help finding your Member ID? Each employer that buys a health plan for its employees also has a number. Aetna Inc. and its subsidiary 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. These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. Treating providers are solely responsible for medical advice and treatment of members. Go to the American Medical Association Web site. CPT only copyright 2015 American Medical Association. 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. Applicable FARS/DFARS apply. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. What is the subscriber ID on an insurance card? Members must obtain prescriptions at contracted pharmacies in Mexico. No fee schedules, basic unit, relative values or related listings are included in CPT. Member ID/Policy Number. 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). Disclaimer of Warranties and Liabilities. For language services, please call the number on your member ID card and request an operator. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Aetna Inc. 151 Farmington Avenue. Visit the secure website, available through www.aetna.com, for more information. This number is always displayed on the cards front. 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. If you only have Original Medicare, you dont have a group number, but your 11-digit Medicare number is on your red, white and blue Medicare card. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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). Group number. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. How to start a insurance broker business? What is the name of the policyholder? Back of card. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. Your Medicare group number must appear on your Medicare Advantage, Medicare Supplement, or Part D insurance card. The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. Your PCP can be altered at any time. All Rights Reserved. View digital copy or choose to print out a replacement copy. If its not there, you may need to call the customer service number, but you also just might not have one if youre not receiving your coverage through your employer. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Medical insurance cards, pharmacy benefit insurance cards, and Medicaid insurance cards are the sorts of insurance cards we will examine. WebCall 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 expense might not This search will use the five-tier subtype. The policy number is generally 8 to 10 digits and listed in the center of the card. So if you purchased your insurance through the Healthcare Market or have a government-based plan such as Medicare, you may not see a group full name (first and last name) address/zip code/email/etc. Our phone service can help with: Answering eligibility and benefits coverage questions. You can also register if you do not know your ID number. See Also: Aetna insurance card policy number Show details Visit www.Aetna.com and click Log In or Register to have access to the Aetna Navigator. 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).

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