Our trusted partnership will afford you and your practice a healthy Detail: Visit URL Category: Health View Health Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. PLEASE NOTE: The Precertification Request form is for provider use only. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Providers cannot request to alter or remove reviews. An exception could be emergency care, when you might receive coverage at the in-network rate. Customer Number 800-925-2272 - by the Numbers. The AMA is a third party beneficiary to this Agreement. Join CAQH UPD. Precertification Request. We're currently processing your request and we'll be in touch soon. **Please select one of the , Health (2 days ago) WebContact us. When you visit the doctor, you may already be a little on edgewithout needing to worry about how your care will be covered! Welcome to the Meritain Health benefits program. When you stay in your network, this usually means a lower deductible, less coinsurance and fewer out-of-pocket expenses for you. 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). And when you have questions, weve got , Health (7 days ago) WebYour online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. **Please select one of the options at the left to proceed with your request. 4.75. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. All rights reserved | Email: [emailprotected], Understanding asian culture in healthcare, How does culture affect health and wellbeing, Home health conditions of participation 2023. The CAQH registration process prevents providers from submitting the same information to . Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Select the Sign icon and , Health (4 days ago) WebHealth Care Providers: Join the Aetna Network. 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). Your online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. 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. Torequest participation in First Health networks, follow the link below. You can learn more by contacting the Customer Service department of your benefits plan. Our trusted partnership will afford you and your practice a healthy , Health WebContact us online Contact us by phone For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) Practice , Health WebMeritain Health Provider Credentialing Health (9 days ago) WebNetwork Participation and Credentialing Providers AmeriHealth Health (Just Now) WebAll providers , Health WebMeritain Health Provider Services Meritain Health. Copyright 2015 by the American Society of Addiction Medicine. 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. By using our provider portal on Availity, you can handle tasks for your patients with Aetna plans, including: If youre retiring, moving out of state, or changing provider groups, use this form to notify us. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Health (1 days ago) WebYour online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. 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. Forgot Username? This means you could end up having to pay a lot more for your care. 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. Prompt claims payment You'll benefit from our commitment to service excellence. Highly recommended Janet Conrad, NP Family Nurse Practitioner Bobtown, VA 5.00 ( 7 reviews) " Outstanding experience. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Need Help? 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. 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. 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. Links to various non-Aetna sites are provided for your convenience only. 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. At Meritain Health, we create unrivaled connections. Our trusted partnership will afford you and your practice a healthy dose of advantages. Treating providers are solely responsible for medical advice and treatment of members. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. This search will use the five-tier subtype. 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. For a faster response, please call us directly at 888-666-8135. 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. Username. 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). After-hours, weekend and holiday services. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. Treating providers are solely responsible for dental advice and treatment of members. 10.0 miles away from Meritain Health Our American Family Insurance agency is committed to inspiring and protecting dreams in Edina, MN. Go to the American Medical Association Web site. Copyright 2023 Meritain Health. Gather Information. We start by getting to know you and your needs, and build a free auto, home or life insurance quote. Privacy Policy Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health. trademark of Sutter Health , Reg. 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. 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. The CAQH Unique provider data source is an online tool that conveniently gathers information required by health plans to obtain provider credentialing. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Reprinted with permission. benefits. The following hospital and/or physician groups accept Meritain Health PPO. Others have four tiers, three tiers or two tiers. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. All rights reserved. Meritain Health Member Services - Meritain Health Member services Contact us Your health and your ability to access your information is important to us. Well need to terminate your existing agreement with us. CPT is a registered trademark of the American Medical Association. Convenient walk-in care clinics for your non-urgent health needs. U.S. Patent & Trademark office. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. The Meritain Health YouTube channel includes lots of videos with more information about topics our members frequently ask about, and much more! **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. 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. 4. 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. What is an in-network provider? Please fill in all fields. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. If you have , https://qa.meritain.com/about-us-self-funded-employee-benefit-plans/meritain-health-provider-services/, Health (5 days ago) WebBecome A Meritain Health Provider Health (4 days ago) WebHealth Care Providers: Join the Aetna Network Health (5 days ago) WebHere's how it works: Step 1. Our Customer Support team is just a phone call away for guidance on COVID-19 information, precertification and all your inquiries. If you have questions about claims or benefits, we're happy to help. When you select a Meritain Health plan, you get . This means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Your patients health and your ability to access their information is important to us. It is a separate process from network contracting. 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. Best time to dial 3:45pm. It is only a partial, general description of plan or program benefits and does not constitute a contract. If you have any questions about your benefits or claims, we're happy to help. 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. 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. Skip To Main Content. If youre still not sure which providers are in your network, dont worry! If you have questions about claims or benefits, we're happy to help. I practice independently and I want to contract with Aetna. After review, Aetna will send your provider agreement via e-mail for signature. Provider termination form and directory update. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. 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. Visit the secure website, available through www.aetna.com, for more information. To help us direct your question or comment to the correct area, please select a category below. Very professional. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. 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. A full breakdown of points can be seen Each main plan type has more than one subtype. 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. PROVIDER RELATIONS APPLICABLE STATE Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 Richardson, TX 75085-3921 (87 Web MD/Emdeon, #41124 or McKesson/Relay Health 1761 (314) 644-4802 ext. 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. 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. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. The 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 email at group_precert-referrals@meritain.com in order for claims to be paid. 69.163.152.136 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. by providers with Doctor.com accounts when editing their profile on Doctor.com. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. Login. You are now being directed to CVS Caremark site. Clicking this button will cancel username recovery and navigate to login page Clicking this button will navigate to the next page Continue Health (3 , Health WebWelcome to Meritain Health At Meritain Health, we create unrivaled connections. All rights reserved. This Agreement will terminate upon notice if you violate its terms. 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. But if youre wondering why to visit doctors in your provider network, you may question how much it actually matters. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Independent retail pharmacies can fill out the form at the link below. Meritain Health offers the resources of a national carrier combined with unmatched flexibility and plan options. Were a proud subsidiary of Aetna and CVS Health . Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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. Less red tape means more peace of mind for you. The action you just performed triggered the security solution. 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. 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). All providers interested in , https://www.amerihealth.com/providers/interactive_tools/credentialing/index.html, 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 , https://polk-county.net/indigent-health-care/polk-healthcare-plan-providers, Health (6 days ago) WebHealth Care Providers: Request to Join the Aetna Network Thank you for your interest in joining our network We are excited that you are interested in joining our quality network , https://extaz-oci.aetna.com/pocui/join-the-aetna-network, Health (9 days ago) WebJoin Our Network Meridian Health Plan of Michigan provider Home JOIN OUR NETWORK Learn more about how being a Meridian provider benefits you. 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. An in-network provider belongs to a group of hospitals, doctors, nurses and other health care providers your health plan has contracted with. Include the date to the template using the Date feature. To obtain a Provider Directory or Specialist Directory please contact Customer Service (863 . And what if youre not sure how to find one? 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.) While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. CPT only Copyright 2022 American Medical Association. Have questions about our products, policies and services? This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. By bundling policies, we can read more in Home & Rental Insurance, Life Insurance, Auto Insurance Department you're calling Customer Service.
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