Youll benefit from our commitment to service excellence. Reprinted with permission. 69.163.152.136 Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. 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. CPT only Copyright 2022 American Medical Association. Please contact your Meritain Health Representative. 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. Password. Very professional. The action you just performed triggered the security solution. benefits. Copyright 2023 Meritain Health. 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. This Aetna provider , Health (6 days ago) WebMeritain Health Provider Enrollment Health (6 days ago) Web (7 days ago) WebFor member or provider questions regarding benefits, claims status or eligibility call Meritain , Health (4 days ago) WebOnline Certification Process. 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. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Login. If youre still not sure which providers are in your network, dont worry! We also take steps to help you save on the cost of your care. Thank you for your interest in joining our networks. provider's profile, including items like having a photo, a biography, Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. The CAQH registration process prevents providers from submitting the same information to . 10.0 miles away from Meritain Health Our American Family Insurance agency is committed to inspiring and protecting dreams in Edina, MN. The Meritain Health YouTube channel includes lots of videos with more information about topics our members frequently ask about, and much more! Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Some subtypes have five tiers of coverage. 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. This Agreement will terminate upon notice if you violate its terms. The following hospital and/or physician groups accept Meritain Health PPO. 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. " insurance, payment options, etc. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Copyright 2023 Meritain Health. 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. 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. This means we can connect you to over 700,000 providers nationwide, unmatched network , Health (Just Now) WebWelcome to Meritain Health's Aetna DocFind site. The Aetna Service Centers help with benefits, claims, appeals, contracted rates, and many other questions. 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. Links to various non-Aetna sites are provided for your convenience only. Have questions or need to connect with us? Some plans exclude coverage for services or supplies that Aetna considers medically necessary. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. What is Precertification and Why Do I Need It. Precertification Request Clinical Update Request Welcome to the Meritain Health benefits program. To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card You can also check out our informational video about the advantages of using in-network providers. Our phone lines are open 24 hours a day, seven days a week. This means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. Welcome to the Meritain Health benefits program. We are excited to share that MeridianCare, a WellCare company, is , Health (Just Now) WebEnsure that the details you fill in Meritain Benefit Enrollment Form Fillable is up-to-date and correct. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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.) Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Meritain Health Provider Enrollment. Click to reveal In most cases, the providers office will make a copy of your ID card for your file so they know in advance how to bill you for the service you receive. Learn more about our clearinghouse vendors here. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). To obtain a Provider Directory or Specialist Directory please contact Customer Service (863 . For serious accidents, injuries and conditions that require immediate medical care. They go above and, Trusted Advisors Since 1984. Privacy Policy Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. You can email the site owner to let them know you were blocked. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. You can learn more by contacting the Customer Service department of your benefits plan. However, if you visit an out-of-network provider, its a little more tricky. What is an in-network provider? This information is neither an offer of coverage nor medical advice. We know it can seem hard to figure out what provider is in-network, so weve put together a couple options to help you locate some. Contact us at 1.800.925.2272 if you have any questions about your plan. Our trusted partnership will afford you and your practice a healthy dose of advantages. This means you could end up having to pay a lot more for your care. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. It helps when you understand the ins and outs of your health care benefits, especially when youre in search of a doctor or health care facility. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. To help us direct your question or comment to the correct area, please select a category below. Provider termination form and directory update. Your patients health and your ability to access their information is important to us. These providers have agreed to discounted rates for the services they offer. 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. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Highly recommended Janet Conrad, NP Family Nurse Practitioner Bobtown, VA 5.00 ( 7 reviews) " Outstanding experience. Less red tape means more peace of mind for you. Health. 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). Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members should discuss any matters related to their coverage or condition with their treating provider. If you have any questions about your benefits or claims, we're happy to help. We're currently processing your request and we'll be in touch soon. How do I find out what doctors are in my network? We start by getting to know you and your needs, and build a free auto, home or life insurance quote. 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. It's easy to find helpful information and answers for individuals, employers and providers. Convenient walk-in care clinics for your non-urgent health needs. ProfilePoints measure the overall completeness of a
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