Category: Health Detail Health. This Aetna provider , Health WebAll providers interested in participating in our networks must complete and return a credentialing application, as explained below. Your browser doesn't support JavaScript code, or you have disabled JavaScript. Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone If you or a covered dependent seek hospital treatment, both inpatient and/or outpatient, in Anchorage, you must use Providence Hospital to receive maximum plan benefits. Meritain Health Provider Services - Meritain Health Provider services Contact us Your patient's health and your ability to access their information is important to us. Join CAQH UPD. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. We are excited to share that MeridianCare, a WellCare company, is , https://corp.mhplan.com/en/join-our-network/, Health (Just Now) WebWelcome to Meritain Health's Aetna DocFind site. CPT is a registered trademark of the American Medical Association. Our trusted partnership will afford you and your practice a healthy dose of advantages. 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. You are always free to visit any health care provider you want, but youll typically receive the best rates when you choose participating (in-network) providers. 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. How do I find out what doctors are in my network? Gather Information. The AMA is a third party beneficiary to this Agreement. 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. To help us direct your question or comment to the correct area, please select a category below. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. To obtain a Provider Directory or Specialist Directory please contact Customer Service (863 . Unlisted, unspecified and nonspecific codes should be avoided. Check-ups, screenings and sick visits for adults and children. Health benefits and health insurance plans contain exclusions and limitations. Independent retail pharmacies can fill out the form at the link below. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. 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. Prompt claims payment You'll benefit from our commitment to service excellence. Treating providers are solely responsible for medical advice and treatment of members. 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. Chain or Pharmacy Services Administrative Organization (PSAO) pharmacies, Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, Availity users log in to send us your questions, Submit a medical or behavioral health question or comment, Submit a National Provider Identifier (NPI), Submit a National Provider Identifier (NPI) exemption, Request clinical review criteria for New York state residents, Participating provider precertification list for Aetna (PDF), Non-Medicare plans, including individual and family plans -, Mental health treatment - use phone number on member's ID card, Substance abuse treatment - use phone number on member's ID card, Non-Medicare, including individual and family plan precertification -, Specialty precertification (injectable drugs) for Medicare plans , Specialty precertification (injectable drugs) for non-Medicare, including individual and family plans , Pharmacy precertification (oral drugs) for Medicare plans , Pharmacy precertification (oral drugs) for non-Medicare, including individual and family plans , BRCA genetic testing (precertification and information) -, National Medical Excellence (transplant related care and cellular therapy services) for Medicare, non-Medicare, including individual and family plans , Participating providers can find more precertification phone numbers in, Availity help - registration questions, help with user name/password -, I am a non-physician health care professional who is not employed by an Aetna-contracted provider (physician group, hospital, etc.) 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. However, if you visit an out-of-network provider, its a little more tricky. Become A Meritain Health Provider Health (4 days ago) Web(5 days ago) WebThe Provider/Specialist who receives the patient referral must submit the completed Specialty Referral form to: Meritain Health, Inc. via fax at (602) 789-9369 or 69.163.152.136 In case of a conflict between your plan documents and this information, the plan documents will govern. ProfilePoints measure the overall completeness of a The action you just performed triggered the security solution. This means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. Learn more about our clearinghouse vendors here. Our Customer Support team is just a phone call away for guidance on COVID-19 information, precertification and all your inquiries. This Agreement will terminate upon notice if you violate its terms. When you select a Meritain Health plan, you get . website and services to function. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Login. What is Precertification and Why Do I Need It. By bundling policies, we can read more in Home & Rental Insurance, Life Insurance, Auto Insurance 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. 3. Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. Links to various non-Aetna sites are provided for your convenience only. These providers have agreed to discounted rates for the services they offer. It is only a partial, general description of plan or program benefits and does not constitute a contract. So, when you visit an in-network provider, it can help ease your mind a bit. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. **Please select one of the , Health (2 days ago) WebContact us. Call picked up by a real person YES. by providers with Doctor.com accounts when editing their profile on Doctor.com. It is important to note that not all of . Our trusted partnership will afford you and your practice a healthy dose of advantages. 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. First, you can request participation in the Aetna network by completing our online request for participation form. At Meritain Health, our goal is simpletake a creative approach to health care and build industry-leading connections. 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. We do our best to streamline our processes so you can focus on tending to patients. Meritain Health Claim Filing Limit. 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. Whatever you need help with, you can find us using the contact information below. Step 2. A healthcare facility or health insurance plan asks the provider for information on his or her background, licenses, , Health WebCredentialing is done before a health care professional joins the Aetna network. This information is neither an offer of coverage nor medical advice. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. Aaron Lissarrague - American Family Insurance, Our American Family Insurance agency is committed to inspiring and protecting dreams, Welcome to the Roderick Youngdahl agency, serving the Maple Grove, MN area since, **You can drop off the information at Debbie's Tax Facts located in Maple Grove, MN, Becky Meierhofer - State Farm Insurance Agent, Thank you for considering Meierhofer Becky Ins. Combined with our own in-house products and valued vendor partnerships, our solutions have placed us as the second largest third party administrator (TPA) in the nation. provider's profile, including items like having a photo, a biography, Links to various non-Aetna sites are provided for your convenience only. CPT only Copyright 2022 American Medical Association. Past Week Applicable FARS/DFARS apply. 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. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Credentialing involves collecting and , Health WebWelcome to Meritain Health's Aetna DocFind site. Provider services Contact us Your patient's health and your ability to access their information is important to us. New and revised codes are added to the CPBs as they are updated. Visit the secure website, available through www.aetna.com, for more information. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. (5 days ago) WebHere's how it works: Step 1. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Were a proud subsidiary of Aetna and CVS Health. U.S. Patent & Trademark office. 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. All Rights Reserved. For Providers Meritain Health Provider Portal Meritain Health WebMeritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. This means we can connect you to over 700,000 providers nationwide, unmatched network , https://qa.meritain.com/?spb-section=welcome-to-meritain-health, Health (2 days ago) WebMeritain Health Provider Services - Meritain Health Provider services Contact us Your patients health and your ability to access their information is important to us. The ABA Medical Necessity Guidedoes not constitute medical advice. Disclaimer of Warranties and Liabilities. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". PLEASE NOTE: The Precertification Request form is for provider use only. Past 24 Hours To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card If you have questions about claims or benefits, we're happy to help. When you stay in your network, this usually means a lower deductible, less coinsurance and fewer out-of-pocket expenses for you. Were a proud subsidiary of Aetna and CVS Health . 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. Cloudflare Ray ID: 7c0ab7761d84efce Youll benefit from our commitment to service excellence. They go above and, Trusted Advisors Since 1984. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 100% Top 10 Meritain Health Provider Specialties: Ophthalmologist (Eye Doctor) (1 providers) States with the most Meritain Health Doctors: New York Florida Cities with the most Meritain Health Doctors: Fort Lauderdale, FL Smithtown, NY Aggregate Statistics Meritain Health Doctors by Specialty Ophthalmologist (Eye Doctor) 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. This page provides an overview of our process: what you need to do and what you can expect , Health WebMetLife is committed to helping our providers have a smooth transition to our new enrollment solution with as little disruption as possible.

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