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. Note: Download the Aetna Mobile App for faster, easier access to your Member ID Card. If you do not intend to leave our site, close this message. 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. In seconds, it will get you to the right person to help you. Your benefits plan determines coverage. INSURANCE. Members should discuss any matters related to their coverage or condition with their treating provider. 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. Medical card example: To process a prescription for medicine, pharmacies often require a pharmacy benefits card, which has a RxGroup, RxPCN, and RxBIN number in addition to the Member ID number. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Treating providers are solely responsible for medical advice and treatment of members. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. The group number on the insurance card identifies the employer that purchased a particular health insurance plan. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Check the back of your card first, as it is not usually on the front! How does south carolina cover wind and hail insurance? What is the difference between a medical insurance card and an insurance card for pharmaceutical benefits? Aetna Inc. and its subsidiary 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 is the phone number for the Corporate Contact Center. Need help finding your Member ID? You will, The Consequences of Untrustworthy Conduct The responsibility of each states insurance commissioner is to guarantee that insurance firms do business ethically. The policy number is usually located on the front of the card, near the top. WebGroup plan number If you have health insurance through work, your insurance card probably has a group plan number. How Long Does It Take to Receive a Check for a Car Accident Settlement? That number is 1-877-261-9951 (TTY:711) . Gross Point of Rating. Webcheck the H&PBP numbers on the bottom right of the ID card. What is the GRP acronym? 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. If you cant find your insurance card, dont Preview / Show more . All Rights Reserved. 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. Another term for a prescription is Rx. Typically, medical cards have merely a Member ID number. Note: Download the Aetna Mobile App for faster, easier access to your Member ID Card. 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. The ABA Medical Necessity Guidedoes not constitute medical advice. They do not have access to member accounts but they can provide Aetna Member Services contact information. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. 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. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. 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. How to become a property and casualty insurance broker? No fee schedules, basic unit, relative values or related listings are included in CPT. Webcheck the H&PBP numbers on the bottom right of the ID card. 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. 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. Checking the status of a claim. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. It is essential for the pharmacy to have this information in order to locate your insurance and obtain reimbursement for your medicines. 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. This is also called your Subscriber ID number, and you can find it on your Health Net insurance card. Click on View Member ID, on the left side of page under family/plans. Gross Point of Rating. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. Your PCP can be altered at any time. Example: W123456789. The table below displays the Rx BIN Numbers and PCNs for California Small Group Health Plans per carrier. WebCall us. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. It is only a partial, general description of plan or program benefits and does not constitute a contract. Your Medicare group number should be on your insurance card for your Medicare Advantage, Medicare Supplement or Part D plan. Insurance contact information. Each main plan type has more than one subtype. This plan offers both in-network and out-of-network benefits; however, the plans reimbursement is higher when you use an in-network provider. There is no option for members to get information at this number. 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). Group number. If you have a Medicaid managed care plan, you should still be able to get information about your pharmacy coverage. The percentage of costs of a covered health care service you pay (20%, for example) after youve paid your deductible. Join us in a conversation about the future of health care. What policy number is shown on an Aetna insurance card? 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 Tweet with us 8 AM to 8 PM ET Monday through Friday @Aetna and 24/7 @Aetna Help. The information you will be accessing is provided by another organization or vendor. Join us in a conversation about the future of healthcare. The majority of pharmacy cards will have all four numbers (Member ID, RxGroup, RxPCN, and RxBIN), although there are a few plans that do not include all four digits but are still approved. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Do you want to continue? What is the subscriber ID on an insurance 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). 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 Members should discuss any matters related to their coverage or condition with their treating provider. 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. What policy number is shown on an Aetna insurance card? You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT. You can add more persons to your insurance as the policyholder, depending on your connection with them. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Box 7012 Downey, CA 90242, Rx PCN for MMA: NCCMS Rx PCN for HDHP: NCHDP Rx PCN for HMO: 70000, HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11172 Rx Group: SC Tax ID: 94-1340523 COB Address P.O. 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. Applicable FARS/DFARS apply. CPT only Copyright 2022 American Medical Association. After thirty days, several states compel Medicaid beneficiaries to transfer to a managed care plan. 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. You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. How to report a disability insurance company for bad faith. While Clinical Policy Bulletins (CPBs) define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. Do you want to continue? For example, on CDPHP ID cards, the group number is located on If your insurance company simply mailed you a medical insurance card, you may often get information about your pharmacy coverage online or by phoning your insurance company (look for the phone number for Member Services on the back of your card). During regular business hours, you can ask to speak with a member services representative. Where Is the Aetna Insurance Card Policy Number? You might look at your Medicare card and wonder Where is my policy number on my insurance card? You may get a discount if you use a NAP doctor. Checking the status of a claim. Everyone covered by your companys insurance will have the same group number. 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. While the Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The number appears on the back of your Aetna identification card. This number is always displayed on the cards front. 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 services deemed "never effective" are excluded from coverage. Need help finding your Member ID? Medical insurance cards, pharmacy benefit insurance cards, and Medicaid insurance cards are the sorts of insurance cards we will examine. Enter your member ID without spaces or dashes. The policy number is usually located on the front of the card, near the top. 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. Treating providers are solely responsible for medical advice and treatment of members. No fee schedules, basic unit, relative values or related listings are included in CPT. For your convenience, we recommend that you add your Member Services number to your phone contacts. You may call the toll-free number on your member ID card at any time. Please ensure that the identification number and date of birth you submit are identical to those on file with the George Washington University. How much does accutane cost with insurance? 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). All Rights Reserved. If youre wondering where to find your group number on your insurance card, that answer is that it usually will show on the front of your card. Question: How To Read Your Health Insurance Card, Quick Answer: How To Read My Health Insurance Card, Quick Answer: Does Health Insurance Card Count As Id, Quick Answer: Can You Use Expired Health Insurance Id Card, Quick Answer: Can You Use Health Insurance Card As Id, How To Access Your Aetna Health Insurance Card Online, Quick Answer: How To Check My Health Benefits Id Card, Quick Answer: Can Health Card Be Used As Photo Id, Question: How To Get My Veterans Health Id Card. What is my Aetna ID number? How long after an accident will insurance go down? Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). As the proprietor of an independent insurance agency, you will enjoy complete independence. 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. back to FAQ listWhere can I find my Member ID number? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Go to the American Medical Association Web site. Each main plan type has more than one subtype. The information you will be accessing is provided by another organization or vendor. To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. Members can go to www.Aetna.com and Log into your account. 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You will, the benefits plan will govern ID number card first, as it is essential for pharmacy.