Po box 981106 el paso tx 79998

Health care providers can use the Aetna dispute and appeal process if they do not agree with a claim or utilization review decision.

Log in. Forgot username? Forgot password? Log in help. Register now for AetnaDental. Register now for Aetna's provider website on Availity. For your convenience, we have a single post office box for claims and specialty authorization submissions.

Po box 981106 el paso tx 79998

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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. Precertification overview Precertification lists and CPT code search. For a complete list of participating walk-in clinics, use our provider lookup.

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Ask us in writing to reconsider our initial decision. You must:. In the case of a post-service claim, we have 30 days from the date we receive your request to:. You or your provider must send the information within 60 days of our request. We will then decide within 30 more days. If we do not receive the information within 60 days we will decide within 30 days of the date the information was due. We will base our decision on the information we already have. We will write to you with our decision. If you do not agree with our decision, you may ask OPM to review it. Note: If you want OPM to review more than one claim, you must clearly identify which documents apply to which claim.

Po box 981106 el paso tx 79998

Health care providers can use the Aetna dispute and appeal process if they do not agree with a claim or utilization review decision. Find dispute and appeal forms. Read our dispute process FAQs. Within 45 business days of receiving the request, depending on the matter in question, and if review by a specialty unit is needed. Within 60 business days of receiving the request. If additional information is needed, within 60 calendar days of receiving that information. See state exceptions to these timeframes. Use our secure provider website to access electronic transactions and valuable resources to support your organization.

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Aetna Inc. Health care providers can use the Aetna dispute and appeal process if they do not agree with a claim or utilization review decision. Go to the American Medical Association Web site. You are now leaving the Aetna Dental website. Please select "Continue to ProVault to begin the contracting and credentialing process. Links to ClaimConnect and its content are provided for your convenience. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Do you want to continue? Log in. Register now for AetnaDental. Log in help. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Clinical policy bulletins. Links to various non-Aetna sites are provided for your convenience only. 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.

Dec 1, Medical billing basics. Aetna has more address but usually accept all the claims whatever address you submit from the below list.

We're working with 3Won to process your request for participation. Find forms for claims, payment, billing, Medicare, pharmacy and more. The Clinical Policy Bulletins CPBs express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Applications are available at the American Medical Association Web site, www. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Dental benefits and dental insurance plans are underwritten by Aetna Dental Inc. You can request more information 24 hours a day at www. Within calendar days of the initial claim decision. The Applied Behavior Analysis ABA Medical Necessity Guide helps determine appropriate medically necessary levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with network providers. Dental Clinic Policy Bulletins.