Please contact your Meritain Health Representative. Meritain Health Member Services - Meritain Health Member services Contact us Your health and your ability to access your information is important to us. 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. The CAQH registration process prevents providers from submitting the same information to . 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. Provider services - Meritain Health 4. 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. The Meritain Health YouTube channel includes lots of videos with more information about topics our members frequently ask about, and much more! 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. Our trusted partnership will afford you and your practice a healthy Detail: Visit URL Category: Health View Health Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. We also take steps to help you save on the cost of your care. An exception could be emergency care, when you might receive coverage at the in-network rate. 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. 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. In case of a conflict between your plan documents and this information, the plan documents will govern. PDF Meritain Health Customer Service - EPC 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 P.O. 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. Welcome to the Meritain Health benefits program. Your benefits plan determines coverage. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. 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. 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. 1000 or toll free 7) 232-3863 ext. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. We're currently processing your request and we'll be in touch soon. When youre caring for a Meritain Health member, were glad to work with you to ensure they receive the very best. Your patients health and your ability to access their information is important to us. Providers cannot request to alter or remove reviews. 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. 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.) trademark of Sutter Health , Reg. 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). Powered by WEX Health WEX Health Inc. 2004-2023. You can learn more by contacting the Customer Service department of your benefits plan. You may not have the same coverage and discounts because out-of-network doctors have not agreed to contracted rates. Meritain Health The CAQH Unique provider data source is an online tool that conveniently gathers information required by health plans to obtain provider credentialing. Meritain Health offers the resources of a national carrier combined with unmatched flexibility and plan options. And our payment, financial and procedural accuracy is above 99 percent. This means you could end up having to pay a lot more for your care. Expertise and advanced technologies in all areas of medicine. Some subtypes have five tiers of coverage. I practice independently and I want to contract with Aetna. We start by getting to know you and your needs, and build a free auto, home or life insurance quote. Our phone lines are open 24 hours a day, seven days a week. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. However, if you visit an out-of-network provider, its a little more tricky. The member's benefit plan determines coverage. 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 means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. To help us direct your question or comment to the correct area, please select a category below. 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. Our trusted partnership will afford you and your practice a healthy dose of advantages. Call picked up by a real person YES. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 4.75. Past month, Health WebMeritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Cobrowse. 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. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Join CAQH UPD. Prompt claims payment You'll benefit from our commitment to service excellence. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Treating providers are solely responsible for dental advice and treatment of members. Contact Us | Meridian 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. PLEASE NOTE: The Precertification Request form is for provider use only. 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 Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. 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. 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. Skip To Main Content. For language services, please call the number on your member ID card and request an operator. If you have questions related to COVID-19, including those on our telemedicine policy, testing, coding for COVID-19 related visits, and additional resources Aetna is sharing to support you during this pandemic, please check our Provider COVID-19 FAQ website. Login. Go to the American Medical Association Web site. , 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. **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. By bundling policies, we can read more in Home & Rental Insurance, Life Insurance, Auto Insurance New and revised codes are added to the CPBs as they are updated. 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. Forgot Username? Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Do you want to continue? Health-mental.org. Department you're calling Customer Service. Aetna Insurance Provider Credentialing - The Process - DENmaar Were a proud subsidiary of Aetna and CVS Health. When you stay in your network, this usually means a lower deductible, less coinsurance and fewer out-of-pocket expenses for you. Call center hours 24 hours, 7 days. 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. You can also check out our informational video about the advantages of using in-network providers. Sutter Health is a registered No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Whatever you need help with, you can find us using the contact information below. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. All rights reserved. This Aetna provider , Health WebAll providers interested in participating in our networks must complete and return a credentialing application, as explained below. (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 . 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. Health (1 days ago) WebYour online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. So, when you visit an in-network provider, it can help ease your mind a bit. Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone It's easy to find helpful information and answers for individuals, employers and providers. Meritain Health Provider Services - Meritain Health All rights reserved. Alta Bates Summit Medical Center - Alta Bates Campus, Alta Bates Summit Medical Center - Summit Campus, Sutter Maternity & Surgery Center of Santa Cruz. Each main plan type has more than one subtype. 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.