Our voice prompt service offers a choice of options for everyday questions. They do not have access to member accounts but they can provide Aetna Member Services contact information. The AMA is a third party beneficiary to this Agreement. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Applicable FARS/DFARS apply. We want to make it easier for you to live healthier. 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. While ID cards vary according to the health plan that designs them, the group number is a vital piece of information that should be included. Check out our post for advice on how to contact your insurance provider. You may call the toll-free number on your member ID card at any time. Enter your member ID without spaces or dashes. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. NAP stands for National Advantage Program. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. 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. 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. Your PCP can be altered at any time. Group number. This number is always displayed on the cards front. 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. In seconds, it will get you to the right person to help you. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. Check the back of your card first, as it is not usually on the front! If its not there, check the back of the card. So if you purchased your insurance through the Healthcare Market or have a government-based plan such as Medicare, you may not see a group Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. If its not there, you may need to call the customer service number, but you also just might not have one if youre not receiving your coverage through your employer. If you just have a medical insurance card and you need information about your pharmacy coverage, you can contact your insurance company. WebYour full legal name as it appears on your Medicare ID card; Your Social Security number (even if you receive benefits through your spouse) Your address and contact info, including your phone number or email address; You may also be For example, on CDPHP ID cards, the group number is located on Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Enter your member ID without spaces or dashes. If you are the policyholder, the last two digits in your number might be 00, while others on the policy might have numbers ending with numeric characters like 01,02, etc. It offers coverage for wind and hail in the legislatively defined, Independent Agents are fully unaffiliated with a parent firm. Visit www.Aetna.com and click Log In or Register to have access to the Aetna Navigator. And if the accident/insurance event occurs, the insurance company will cover all or a portion of the costs. What is the GRP acronym? We want to make it easier for you to live healthier. The insurance company name and plan type are in the top header of the card. See Also: Aetna insurance card policy number Show details The member should call that number to activate the card and then try to pay again. CPT is a registered trademark of the American Medical Association. How to report a disability insurance company for bad faith. INSURANCE. CPT only Copyright 2022 American Medical Association. 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. The insurance company uses this number to identify your employers health insurance policy. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Treating providers are solely responsible for dental advice and treatment of members. The group number on the insurance card identifies the employer that purchased a particular health insurance plan. Some subtypes have five tiers of coverage. When billing, you must use the most appropriate code as of the effective date of the submission. 1-800-US-AETNA ( 1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. 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 is identified through the group number. 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. The National Advantage Program (NAP) offers you access to Aetna-contracted rates for many hospital and doctor expenses that would otherwise be billed at the providers normal rate. What is my Aetna ID number? Webnumber is listed on the back of your Aetna ID card. How Long Does It Take to Receive a Check for a Car Accident Settlement? Copyright 2015 by the American Society of Addiction Medicine. So if you purchased your insurance through the Healthcare Market or have a government-based plan such as Medicare, you may not see a group 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. The person who pays for health insurance premiums or whose employment is the basis for membership in the insurance plan. That number is 1-877-261-9951 (TTY:711) . This is the phone number for the Corporate Contact Center. Both your group number and your member ID number will be located on your physical ID card and your mobile ID card, which is available on your SimplyInsured dashboard. These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. What is a policy number? Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Box 7012 Downey, CA 90242, Rx PCN for MMA: SCCMS Rx PCN for HDHP: SCHP Rx PCN for HMO: 70000. For general inquiries, reach our corporate headquarters at 1-888-US-AETNA (1-800-872-3862) (TTY: 711). Links to various non-Aetna sites are provided for your convenience only. Everyone covered by your companys insurance will have the same group number. After thirty days, several states compel Medicaid beneficiaries to transfer to a managed care plan. Others have four tiers, three tiers or two tiers. The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). Need help finding your Member ID? To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. Employers can also locate the company's group number on What does GRP mean on an Aetna card? 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). WebYou can find your member ID number on your member ID card. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. Members should discuss any matters related to their coverage or condition with their treating provider. A Florida Medicaid card and a Florida Medicaid managed care card are seen below. 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. A car insurance policy number is a unique number assigned to you by your car insurance company. 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. The best place to find details about your coverage and benefits is your secure member website. Your Medicare group number should be on your insurance card for your Medicare Advantage, Medicare Supplement or Part D plan. Question: How To Read Aetna Health Insurance Card. This number is always displayed on the cards front. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. Webcheck the H&PBP numbers on the bottom right of the ID card. 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. An insurance group number, if you have an employer-based plan. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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). What is subscriber number on insurance card Aetna? During regular business hours, you can ask to speak with a member services representative. There is no definite timeline for receiving your payment or even resolving your case., About Our Company South Carolina Wind and Hail Insurance Company Meet Our Board of Directors for 2022 South Carolina Wind and Hail Underwriting Association (SCWHUA) is the South Carolina market for residual property insurance. 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