General Dentists: provide all the services you need to maintain healthy teeth and gums. The ABA Medical Necessity Guidedoes not constitute medical advice. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 2/22). If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Oral and maxillofacial surgeons: focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. 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. Please review the plan benefit coverage documentation under the link below. The member's benefit plan determines coverage. 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 . 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. Just scroll down to "Find local care. Find a Provider. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Aetna Dentists Near Me. You are now being directed to the CVS Health site. 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. 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. To get started: 1. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. From there, you can search for providers and specialists, like dentists, eye doctors, therapists, dermatologists and more. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The AMA is a third party beneficiary to this Agreement. 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. Category: Health Detail Health. Dental Savings Plans reduce the cost of dental care by 10%-60%, at thousands of participating dentists and dental specialists nationwide. 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. CPT is a registered trademark of the American Medical Association. 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. 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. 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. Do you want to continue? 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. Links to various non-Aetna sites are provided for your convenience only. Prior Authorization may be required. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. 2020 Guardian. 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. CPT only Copyright 2022 American Medical Association. Treating providers are solely responsible for medical advice and treatment of members. #2020 . Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Links to various non-Aetna sites are provided for your convenience only. 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. 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. Have an update for our Directory? Prior Authorization may be required. Our find a dentist tool includes a brief survey to help us improve this service. Geographic Search. Please consult with the respective plan detail page for additional plan terms. Treating providers are solely responsible for dental advice and treatment of members. You will receive the discount off the providers usual and customary fees when you pay. 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. Unlisted, unspecified and nonspecific codes should be avoided. 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. By submitting your information you are agreeing to receive communications from Aetna Dental Offers. Street Address: City: State: County: Zip Code: Radius: . Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. For Use by Doctors and Facilities only. You can narrow your Aetna provider search by filtering provider characteristics, geographic location and best matched . Health benefits and health insurance plans contain exclusions and limitations. Provider Directory Aetna Better Health of Pennsylvania. The member's benefit plan determines coverage. 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. Some subtypes have five tiers of coverage. Copyright document.write(new Date().getFullYear()) Aetna Better Health of Illinois, All Right Reserved. 2. Links to various non-Aetna sites are provided for your convenience only. Prosthodontists: restore damaged teeth or replace missing ones, with procedures that include dental implants, bridges, crowns and dentures. 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. CPT is a registered trademark of the 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. Do you want to continue? Avsis provides vision and dental claim and administrative services by agreement with Aetna Inc. 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. Explore our savings, quality care and wellness solutions to craft the perfect plan for your business. 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. Periodontists: these dentists specialize in treating complex cases of gum disease, along with other infections or problems involving the tissues that support the teeth. Reprinted with permission. Street Address: . Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. 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'll find these doctors with the label "Quality Care," "Effective Care" or both in your search. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Medicaid. You can also get the materials you need in a different language or format. Want to help transform health care? Treating providers are solely responsible for medical advice and treatment of members. Go to the American Medical Association Web site. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. 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. CPT is a registered trademark of the American Medical Association. 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. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. CPT is a registered trademark of the American Medical Association. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. To search for a dentist, please choose a state, your plan and enter the zip code under the Enter Your Geographic Area section. The term prior authorization (PA) means the utilization review process determines whether the requested service, procedure, prescription drug or medical device meets the companys clinical criteria for coverage. Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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). Neither Aetna Inc. nor its subsidiaries are Guardian affiliates. Health (8 days ago) AdHighly-reviewed Dentists who take your insurance and are ready to see you. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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 . 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).
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