All Time When you stay in your network, this usually means a lower deductible, less coinsurance and fewer out-of-pocket expenses for you. Our trusted partnership will afford you and your practice a healthy dose of advantages. 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. Youll benefit from our commitment to service excellence. The Aetna Service Centers help with benefits, claims, appeals, contracted rates, and many other questions. 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. So, when you visit an in-network provider, it can help ease your mind a bit. 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. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. This search will use the five-tier subtype. 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. Our phone lines are open 24 hours a day, seven days a week. 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). This site has been specially designed to provide quick and easy access to the Aetna provider directory. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. (6 days ago) Web (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 . 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. Meritain Health Provider Enrollment. Total number of Providers on Doctor.com who Accept Meritain Health: Most popular medical specialty of providers who accept Meritain Health: Meritain Health providers listed on Doctor.com have been practicing for an average of: Average ProfilePoints score for Providers who take Meritain Health: Average Overall User Rating for providers who take Meritain Health. If you do not intend to leave our site, close this message. Customer Number 800-925-2272 - by the Numbers. 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 | 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. 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. www.meritain.com . 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 Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. 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. 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. This site has been specially designed to provide quick and easy access to the Aetna provider directory. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. 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). 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. If youre still not sure which providers are in your network, dont worry! Alta Bates Summit Medical Center - Alta Bates Campus, Alta Bates Summit Medical Center - Summit Campus, Sutter Maternity & Surgery Center of Santa Cruz. These providers have agreed to discounted rates for the services they offer. U.S. Patent & Trademark office. WEX Health Inc. 2004-2023. We use cookies and limited processing of your personal information for our The CAQH registration process prevents providers from submitting the same information to . David Chow is a well-rounded ophthalmologist serving his patients in Reston and Vienna, VA. Dr. Chow, who has been in practice since 1982, currently serves as Chair on the Political Action Committee Board of the Medical Society of Virginia, Richmond, VA. and he is President Emeritus of the Medical Society of Northern . (5 days ago) WebHere's how it works: Step 1. We're currently processing your request and we'll be in touch soon. No fee schedules, basic unit, relative values or related listings are included in CPT. When youre caring for a Meritain Health member, were glad to work with you to ensure they receive the very best. Aetna Claim Address|Aetna Provider Phone Number Updated (2023) December 23, 2022 by NSingh Aetna Provider Phone number and Aetna Claim address are updated from trusted and authorized online resources as per the latest updates. Go to the American Medical Association Web site. Welcome to Meritain Health At Meritain Health, we create unrivaled connections. For serious accidents, injuries and conditions that require immediate medical care. 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. 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. by providers with Doctor.com accounts when editing their profile on Doctor.com. Select the Sign icon and , Health (4 days ago) WebHealth Care Providers: Join the Aetna Network. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Phone number to dial 800-925-2272. The responsibility for the content of this product is with Aetna, Inc. and no endorsement by the AMA is intended or implied. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. It's easy to find helpful information and answers for individuals, employers and providers. These providers have agreed to discounted rates for the services they offer. To obtain a Provider Directory or Specialist Directory please contact Customer Service (863 . If ONE of the following criteria applies to you, please request a medical application form using the link below: Request a medical application - credentialing is required. To help us direct your question or comment to the correct area, please select a category below. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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). Treating providers are solely responsible for medical advice and treatment of members. 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. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Health. How do I find out what doctors are in my network? Well need to terminate your existing agreement with us. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. 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 you have questions about claims or benefits, were happy to help. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. We use cookies to give you the best possible user experience. Department you're calling Customer Service. Have other questions about your health care benefits? By continuing to use the site, you agree to the use of cookies. 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. 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. They go above and, Trusted Advisors Since 1984. 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. 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.) 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). PLEASE NOTE: The Precertification Request form is for provider use only. 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. Links to various non-Aetna sites are provided for your convenience only. Our trusted partnership will afford you and your practice a healthy dose of advantages. Prompt claims payment You'll benefit from our commitment to service excellence. 1000 MO IL KS Essence Healthcare Essence Healthcare New and revised codes are added to the CPBs as they are updated. 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). It's easy to update a provider address, phone number, fax number, email address or initiate an out-of-state move or a change in provider group. All rights reserved. Were a proud subsidiary of Aetna and CVS Health. 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. You are now being directed to the CVS Health site. And what if youre not sure how to find one? Meritain Health Member Services - Meritain Health Member services Contact us Your health and your ability to access your information is important to us. When billing, you must use the most appropriate code as of the effective date of the submission. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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. Meridian Phone Members: 888-437-0606 (TTY 711) Providers: 888-773-2647 (TTY 711) Meridian's regular business hours are Mon - Friday 8am-6:30pm EST. Navigate phone maze to a human Press 2, 0#, 0#, and 0# and you will be transferred. All rights reserved. But if youre wondering why to visit doctors in your provider network, you may question how much it actually matters. CPT is a registered trademark of the American Medical Association. Do you want to continue? Please contact your Meritain Health Representative. 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. , 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. Clicking this button will cancel username recovery and navigate to login page Clicking this button will navigate to the next page Continue Our trusted partnership will afford you and your practice a healthy dose of advantages. Your online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. Completing the Application Once you have , https://denmaar.com/aetna-insurance-provider-credentialing/, Healthcare information security certification, Dc department of health and licensing search, Washington state mental health license lookup, Car insurance for healthcare professionals, Ohiohealth physician group primary care, 2021 health-improve.org. You are always free to visit any health care provider you want, but youll typically receive the best rates when you choose participating (in-network) providers. Username. Reprinted with permission. All rights reserved. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. It is a separate process from network contracting. I may or may not be employed by an Aetna-contracted provider. Were a proud subsidiary of Aetna and CVS Health . Copyright 2023 Meritain Health. Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health. CPT only copyright 2015 American Medical Association. 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. 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. Health benefits and health insurance plans contain exclusions and limitations. 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. Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). Please contact your Meritain Health Representative. Cobrowse. Password. We start by getting to know you and your needs, and build a free auto, home or life insurance quote. Visit the secure website, available through www.aetna.com, for more information. Call-back available NO. Providers cannot request to alter or remove reviews. Sutter Health is a registered CPT is a registered trademark of the American Medical Association. And when you have questions, weve got , Health (3 days ago) WebAt Meritain Health, we create unrivaled connections. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. The Meritain Health YouTube channel includes lots of videos with more information about topics our members frequently ask about, and much more! 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. And our payment, financial and procedural accuracy is above 99 percent. We're a proud subsidiary of Aetna and CVS Health . 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. This means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. provider's profile, including items like having a photo, a biography, This Aetna provider , https://www.aetna.com/docfind/jsp/rdIndex.jsp?site_id=mymeritain&langpref=en, Health (5 days ago) WebHere's how it works: Step 1. Login. 10.0 miles away from Meritain Health Our American Family Insurance agency is committed to inspiring and protecting dreams in Edina, MN. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. After-hours, weekend and holiday services. Welcome to the Meritain Health benefits program. Health (1 days ago) WebYour online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. Cloudflare Ray ID: 7c0ab7761d84efce We take our mission as Advocates for Healthier Living seriouslyand cant wait to support you! 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. In case of a conflict between your plan documents and this information, the plan documents will govern. Check-ups, screenings and sick visits for adults and children. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. For language services, please call the number on your member ID card and request an operator. Click to reveal Copyright 2023 Meritain Health. Torequest participation in First Health networks, follow the link below. This Agreement will terminate upon notice if you violate its terms. If youre moving or changing jobs, you can sign a new agreement for your new practice or location. This site has been specially designed to provide quick and easy access to the Aetna provider directory. This Aetna provider , Health WebAll providers interested in participating in our networks must complete and return a credentialing application, as explained below. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Past Week 69.163.152.136 3. 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 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. 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. This information is neither an offer of coverage nor medical advice. 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. Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Less red tape means more peace of mind for you. When you select a Meritain Health plan, you get . Applicable FARS/DFARS apply. Treating providers are solely responsible for dental advice and treatment of members. Note: If you are a hospital based provider seeking to join an already contracted group, you do not need to complete the application independently. 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. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Please log in to your secure account to get what you need. However, if you visit an out-of-network provider, its a little more tricky. You can also check out our informational video about the advantages of using in-network providers. The action you just performed triggered the security solution. All Rights Reserved. What is an in-network provider? Meritain Health works closely with provider networks, large and small, across the nation. You may not have the same coverage and discounts because out-of-network doctors have not agreed to contracted rates. All services deemed "never effective" are excluded from coverage. An in-network provider belongs to a group of hospitals, doctors, nurses and other health care providers your health plan has contracted with. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). 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. 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) Provider termination form and directory update. When you visit the doctor, you may already be a little on edgewithout needing to worry about how your care will be covered! Meritain Health offers the resources of a national carrier combined with unmatched flexibility and plan options. 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 CAQH Unique provider data source is an online tool that conveniently gathers information required by health plans to obtain provider credentialing. Performance & security by Cloudflare. Providers should , Health (4 days ago) WebSee how you can join Meridian Health Plan's provider network quickly and easily online. 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 AMA is a third party beneficiary to this Agreement. **Please select one of the options at the left to proceed with your request. Forgot Username? All rights reserved. **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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. Each main plan type has more than one subtype. Unlisted, unspecified and nonspecific codes should be avoided. If you have questions about claims or benefits, we're happy to help. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Please note that providers listed in this directory may perform . Disclaimer of Warranties and Liabilities.
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