meritain health provider 15. maj 2023 Your online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. In 2020, we turned around 95.6 percent of claims within 10 business days. Members should discuss any matters related to their coverage or condition with their treating provider. At Meritain Health, we create unrivaled connections. , Health (5 days ago) WebTo locate a physician or facility for treatment participating with Meritain: Please call Meritain Health at 1-800-343-3140 for help finding an in-network provider. 4. CPT is a registered trademark of the American Medical Association. by providers with Doctor.com accounts when editing their profile on Doctor.com. By using our site, you agree to our use of cookies and our, Rheumatologist (Joints & Arthritis Specialist), Physiatrist (Physical Medicine & Rehabilitation), Speech, Language and Hearing Service Providers, Gastroenterologist (Stomach & Bowel Specialist), Pediatrician (Kids / Children Specialist). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. Meritain Health works closely with provider networks, large and small, across the nation. 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. A full breakdown of points can be seen 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. Were a proud subsidiary of Aetna and CVS Health . Have questions about our products, policies and services? Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. What is Precertification and Why Do I Need It. Step 2. We're currently processing your request and we'll be in touch soon. 10.0 miles away from Meritain Health Our American Family Insurance agency is committed to inspiring and protecting dreams in Edina, MN. 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. Username. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. You can access the online provider portal here. This site has been specially designed to provide quick and easy access to the Aetna provider directory. www.meritain.com . You can email the site owner to let them know you were blocked. The AMA is a third party beneficiary to this Agreement. All services deemed "never effective" are excluded from coverage. Clinical Update Request. 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. However, . Welcome to Meritain Health's Aetna DocFind site. Information obtained during the , Health WebCredentialing Process Overview . An in-network provider belongs to a group of hospitals, doctors, nurses and other health care providers your health plan has contracted with. Our Customer Support team is just a phone call away for guidance on COVID-19 information, precertification and all your inquiries. 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. First, you can , https://www.health-improve.org/become-a-meritain-health-provider/, Health (4 days ago) WebOnline Certification Process Skip To Main Content Precertification Request Clinical Update Request Welcome to the Meritain Health benefits program. By showing providers with higher ProfilePoints first, Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Your browser doesn't support JavaScript code, or you have disabled JavaScript. 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. 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. It is important to note that not all of . Meritain Health Claim Filing Limit. No fee schedules, basic unit, relative values or related listings are included in CPT. Join CAQH UPD. Click to reveal Please note that providers listed in this directory may perform . Please fill in all fields. Navigate phone maze to a human Press 2, 0#, 0#, and 0# and you will be transferred. Whether you're building an employee benefits program, researching your member benefits or offering support to your patients, we're ready to help you do more with your health plan. Our trusted partnership will afford you and your practice a healthy dose of advantages. Our trusted partnership will afford you and your practice a healthy dose of advantages. All rights reserved | Email: [emailprotected], Understanding asian culture in healthcare, How does culture affect health and wellbeing, Home health conditions of participation 2023. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. If you have questions about claims or benefits, we're happy to help. You can also check out our informational video about the advantages of using in-network providers. 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 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. Go to the American Medical Association Web site. Cookie Preferences. And when you have questions, weve got answers! Next, well evaluate the , https://www.aetna.com/health-care-professionals/join-the-aetna-network.html, Health (Just Now) WebNetwork Participation and Credentialing Thank you for your interest in becoming a participating provider in AmeriHealths provider networks. You are now being directed to CVS Caremark site. Click , https://corp.mhplan.com/en/provider/michigan/meridianhealthplan/join/, Health (9 days ago) WebThe medical practitioners are required to login to the CAQH page to complete and activate the registration process. Copyright 2015 by the American Society of Addiction Medicine. insurance, payment options, etc. 4.75. 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. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. CPT is a registered trademark of the American Medical Association. Category: Health Detail Health. For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination Request a medical application Request Part D pharmacy participation Request participation in First Health Submit feedback Find frequently asked questions (FAQs) Find more options under: The member's benefit plan determines coverage. To help us direct your question or comment to the correct area, please select a category below. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Clinical Policy Bulletins (CPBs). Copyright 2023 Sutter Health. 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. CPT only copyright 2015 American Medical Association. 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. To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card When you visit the doctor, you may already be a little on edgewithout needing to worry about how your care will be covered! Our trusted partnership will afford you and your practice a healthy Detail: Visit URL Category: Health View Health The following hospital and/or physician groups accept Meritain Health PPO. Links to various non-Aetna sites are provided for your convenience only. Your patients health and your ability to access their information is important to 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. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. Find a Northern Californian Provider that meets your needs. Provider termination form and directory update. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. When you visit an out-of-network provider, its common to pay up front and then file a claim for reimbursement according to your out-of-network benefits (if this is part of your plan coverage). (5 days ago) WebHere's how it works: Step 1. 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. At this time, only PPO , Maryland licensed environmental health specialist, Mesa county health department grand junction, Behavioral health park nicollet st louis park, Missouri department of behavioral health, Community health network medical record, 2019 Healthmoom.com. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". All rights reserved. We use cookies to give you the best possible user experience. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Links to various non-Aetna sites are provided for your convenience only. 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. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The CAQH Unique provider data source is an online tool that conveniently gathers information required by health plans to obtain provider credentialing. When youre caring for a Meritain Health member, were glad to work with you to ensure they receive the very best. 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) 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. It is important to note that not all of the Sutter Health network of providers necessarily participate in all of a health plan's products or networks. For serious accidents, injuries and conditions that require immediate medical care. Applicable FARS/DFARS apply. The action you just performed triggered the security solution. 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 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. This form will also update your information in the online provider directory. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Your benefits plan determines coverage. And our payment, financial and procedural accuracy is above 99 percent. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. New and revised codes are added to the CPBs as they are updated. This search will use the five-tier subtype. **Please select one of the , 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 , https://www.health-mental.org/become-a-meritain-health-provider/, Health (4 days ago) WebSee how you can join Meridian Health Plan's provider network quickly and easily online. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Please contact your Meritain Health Representative. WEX Health Inc. 2004-2023. 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 only Copyright 2022 American Medical Association. Our trusted partnership will afford you and your practice a healthy dose of advantages. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. The information you will be accessing is provided by another organization or vendor. Copyright 2023 Meritain Health. 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. Each main plan type has more than one subtype. Expertise and advanced technologies in all areas of medicine. Others have four tiers, three tiers or two tiers. 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. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage. Why to Visit Doctors in Your Provider Network, Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health, All About Spending Accounts: HRAs, FSAs and HSAs, The Importance of Good Financial Wellness. I may or may not be employed by an Aetna-contracted provider. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. Prompt claims payment You'll benefit from our commitment to service excellence. Gather Information. This site has been specially designed to provide quick and easy access to the Aetna provider directory. With Aetna's financial backing and 30-plus years of operational excellence, you can rest assured knowing Meritain Health has the experience and resources to keep your plan. For 24-hour , Health (6 days ago) WebAddress, phone number, and practice changes For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) , Health (7 days ago) WebMeritain Health 4 Benefit Highlights Nationwide provider access at a discount When you and your family seek health care services, you have access to Aetnas broad national , Health (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 submit via , Health (7 days ago) WebFor member or provider questions regarding benefits, claims status or eligibility call Meritain Health Member Services at 1.800.762.2234 or visit www.MERITAIN.com. Past Week Do you want to continue? All Rights Reserved. Department you're calling Customer Service. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. All rights reserved. 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). 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). All rights reserved | Email: [emailprotected], Meritain health check patient eligibility, Maryland licensed environmental health specialist, Mesa county health department grand junction, Behavioral health park nicollet st louis park. 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. 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. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Please check with your health plan if you have questions about coverage and network providers for specific products. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Clicking this button will cancel username recovery and navigate to login page Clicking this button will navigate to the next page Continue 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). If you have questions about claims or benefits, we're happy to help. Links to various non-Aetna sites are provided for your convenience only. All rights reserved | Email: [emailprotected], Healthcare information security certification, Dc department of health and licensing search, Washington state mental health license lookup, Car insurance for healthcare professionals. Health (1 days ago) WebYour online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. Copyright 2023 Meritain Health. If you have questions about claims or benefits, were happy to help. Disclaimer of Warranties and Liabilities. PLEASE NOTE: The Precertification Request form is for provider use only. This means you could end up having to pay a lot more for your care. And when you have questions, weve got , Health (3 days ago) WebAt Meritain Health, we create unrivaled connections. So, when you visit an in-network provider, it can help ease your mind a bit. 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.) How do I find out what doctors are in my network? 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. Past 24 Hours 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. For a faster response, please call us directly at 888-666-8135. Less red tape means more peace of mind for you. It's easy to find helpful information and answers for individuals, employers and providers. Health (3 , Health WebWelcome to Meritain Health At Meritain Health, we create unrivaled connections. Visit the secure website, available through www.aetna.com, for more information. The following hospital and/or physician groups accept Meritain Health PPO. You can learn more by contacting the Customer Service department of your benefits plan. By continuing to use the site, you agree to the use of cookies. 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 means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. This website is using a security service to protect itself from online attacks. All rights reserved. An exception could be emergency care, when you might receive coverage at the in-network rate. 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. Providers cannot request to alter or remove reviews. 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. After-hours, weekend and holiday services. In case of a conflict between your plan documents and this information, the plan documents will govern. 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. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Please contact your Meritain Health Representative. provider's profile, including items like having a photo, a biography, Performance & security by Cloudflare. Forgot Username? We're a proud subsidiary of Aetna and CVS Health . 1000 MO IL KS Essence Healthcare Essence Healthcare Precertification Request. The CAQH registration process prevents providers from submitting the same information to . Powered by WEX Health Some plans exclude coverage for services or supplies that Aetna considers medically necessary. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The ABA Medical Necessity Guidedoes not constitute medical advice. Cobrowse. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. Call center hours 24 hours, 7 days. Youll be joining a community of like-minded individuals, focused on wellness. It is only a partial, general description of plan or program benefits and does not constitute a contract. I practice independently and I want to contract with Aetna. 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. Aetna Claim Address And Aetna Provider Phone Number: Aetna Medicare Providers Claim Address and Phone Number Our trusted partnership will afford you and your practice a healthy , https://www.meritain.com/resources-for-providers-meritain-health-provider-portal/, Health (3 days ago) WebAt Meritain Health, we create unrivaled connections. 1000 or toll free 7) 232-3863 ext. While we strive to keep this list up to date, it's always best to check with your health plan to determine the specific details of your coverage, including benefit designs and Sutter provider participation in your provider network. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. Were a proud subsidiary of Aetna and CVS Health . Contact us at 1.800.925.2272 if you have any questions about your plan. 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. Meritain Health Customer Service When you need more information We are Meritain Health As Advocates for Healthier Living, we provide easy-to-use health care benefits you can use to live well. 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