At Meritain Health, we create unrivaled connections. 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. A full breakdown of points can be seen The Meritain Health YouTube channel includes lots of videos with more information about topics our members frequently ask about, and much more! Meritain Health Claim Filing Limit. Meritain Health P.O. The action you just performed triggered the security solution. This Aetna provider , Health (6 days ago) WebMeritain Health Provider Enrollment Health (6 days ago) Web (7 days ago) WebFor member or provider questions regarding benefits, claims status or eligibility call Meritain , Health (4 days ago) WebOnline Certification Process. Your benefits plan determines coverage. Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone You can learn more by contacting the Customer Service department of your benefits plan. 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). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Have questions or need to connect with us? We start by getting to know you and your needs, and build a free auto, home or life insurance quote. 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. CPT is a registered trademark of the American Medical Association. 3. We're a proud subsidiary of Aetna and CVS Health . Credentialing involves collecting and , Health WebWelcome to Meritain Health's Aetna DocFind site. 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.) 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. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. By continuing to use the site, you agree to the use of cookies. After review, Aetna will send your provider agreement via e-mail for signature. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. This site has been specially designed to provide quick and easy access to the Aetna provider directory. Privacy Policy The member's benefit plan determines coverage. An exception could be emergency care, when you might receive coverage at the in-network rate. When youre caring for a Meritain Health member, were glad to work with you to ensure they receive the very best. 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. Convenient walk-in care clinics for your non-urgent health needs. 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. Learn more about our clearinghouse vendors here. 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. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. Welcome to Meritain Health's Aetna DocFind site. Aetna Claim Address And Aetna Provider Phone Number: Aetna Medicare Providers Claim Address and Phone Number 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. And when you have questions, weve got answers! We do our best to streamline our processes so you can focus on tending to patients. I practice independently and I want to contract with Aetna. You may not have the same coverage and discounts because out-of-network doctors have not agreed to contracted rates. Department you're calling Customer Service. First, you can request participation in the Aetna network by completing our online request for participation form. This Agreement will terminate upon notice if you violate its terms. Gather Information. 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. To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card Each main plan type has more than one subtype. by providers with Doctor.com accounts when editing their profile on Doctor.com. Please check with your health plan if you have questions about coverage and network providers for specific products. In 2020, we turned around 95.6 percent of claims within 10 business days. All rights reserved. Youll benefit from our commitment to service excellence. Ready to journey on with us? Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. we make it easier for you to quickly identify the most informative profiles on Doctor.com. First, you can request participation in the Aetna network by completing , Understanding asian culture in healthcare, How does culture affect health and wellbeing, Home health conditions of participation 2023, 2022 health-mental.org. Links to various non-Aetna sites are provided for your convenience only. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Precertification Request Clinical Update Request Welcome to the Meritain Health benefits program. We know it can seem hard to figure out what provider is in-network, so weve put together a couple options to help you locate some. Cobrowse. Please log in to your secure account to get what you need. Were a proud subsidiary of Aetna and CVS Health . WEX Health Inc. 2004-2023. 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. 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. New and revised codes are added to the CPBs as they are updated. Credentialing and joining our network - 1-800-353-1232 (TTY: 711). 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. 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. Click to reveal Have questions about our products, policies and services? 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. To help us direct your question or comment to the correct area, please select a category below. 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. I may or may not be employed by an Aetna-contracted provider. Links to various non-Aetna sites are provided for your convenience only. Include the date to the template using the Date feature. 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. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Information obtained during the , Health WebCredentialing Process Overview . Health (1 days ago) WebYour online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. 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. Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Meritain Health insurance. 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 nationwide, unmatched network , https://qa.meritain.com/?spb-section=welcome-to-meritain-health, Health (2 days ago) WebMeritain Health Provider Services - Meritain Health Provider services Contact us Your patients health and your ability to access their information is important to us. How do I find out what doctors are in my network? Health. (6 days ago) WebTimely Filing Limit 2023 of all Major Insurances Health (4 days ago) WebThe timely filing limit varies by insurance company and typically ranges from 90 to 180 days. Meritain Health Doctors nearby with great reviews Zocdoc only allows patients to write reviews if we can verify they have seen the provider. This search will use the five-tier subtype. And when you have questions, weve got , Health (3 days ago) WebAt Meritain Health, we create unrivaled connections. Very professional. The member's benefit plan determines coverage. Copyright 2023 Meritain Health. And what if youre not sure how to find one? If you have questions about claims or benefits, were happy to help. Applicable FARS/DFARS apply. 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. Providers cannot request to alter or remove reviews. Have other questions about your health care benefits? The AMA is a third party beneficiary to this Agreement. The CAQH Unique provider data source is an online tool that conveniently gathers information required by health plans to obtain provider credentialing. So, when you visit an in-network provider, it can help ease your mind a bit. The information you will be accessing is provided by another organization or vendor. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Past month, Health WebMeritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. By using our site, you agree to our use of cookies and our, Rheumatologist (Joints & Arthritis Specialist), Physiatrist (Physical Medicine & Rehabilitation), Speech, Language and Hearing Service Providers, Gastroenterologist (Stomach & Bowel Specialist), Pediatrician (Kids / Children Specialist). 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 . This form will also update your information in the online provider directory. Clinical Update Request. 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. Gwizdala & Associates offers tax, bookkeeping and. 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. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Meritain Health works closely with provider networks, large and small, across the nation. Were a proud subsidiary of Aetna and CVS Health . Well need to terminate your existing agreement with us. 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. Our trusted partnership will afford you and your practice a healthy dose of advantages. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. 1000 or toll free 7) 232-3863 ext. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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). 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. An in-network provider belongs to a group of hospitals, doctors, nurses and other health care providers your health plan has contracted with. When you visit the doctor, you may already be a little on edgewithout needing to worry about how your care will be covered! All Rights Reserved. You are now being directed to CVS Caremark site. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. Links to various non-Aetna sites are provided for your convenience only. Navigate phone maze to a human Press 2, 0#, 0#, and 0# and you will be transferred. Applicable FARS/DFARS apply. Sutter Health is a registered This means you could end up having to pay a lot more for your care. In case of a conflict between your plan documents and this information, the plan documents will govern. Forgot Username? We also take steps to help you save on the cost of your care. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Meritain Health Provider Enrollment. Please contact your Meritain Health Representative. Login. However, if you visit an out-of-network provider, its a little more tricky. Highly recommended Janet Conrad, NP Family Nurse Practitioner Bobtown, VA 5.00 ( 7 reviews) " Outstanding experience. Health WebMeritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million , Health WebMeritain Health Credentialing New Provider Health (3 days ago) WebMeritain Health Credentialing Health (Just Now) WebProvider services - Meritain Health. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. (5 days ago) WebHere's how it works: Step 1. This site has been specially designed to provide quick and easy access to the Aetna provider directory. 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. 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. www.meritain.com . If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Contact us at 1.800.925.2272 if you have any questions about your plan. This site has been specially designed to provide quick and easy access to the Aetna provider directory. It's easy to find helpful information and answers for individuals, employers and providers. This means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. 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. Category: Health Detail Health. All rights reserved. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 69.163.152.136 Skip To Main Content. For language services, please call the number on your member ID card and request an operator. The following hospital and/or physician groups accept Meritain Health PPO. It is important to note that not all of . 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. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. You can also check out our informational video about the advantages of using in-network providers. 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. 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. 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. However, . By bundling policies, we can read more in Home & Rental Insurance, Life Insurance, Auto Insurance Treating providers are solely responsible for medical advice and treatment of members. 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). Performance & security by Cloudflare. 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. Copyright 2023 Meritain Health. 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. 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. This information is neither an offer of coverage nor medical advice. Welcome to Meritain Health At Meritain Health, we create unrivaled connections. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Please fill in all fields. Reprinted with permission. 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. Others have four tiers, three tiers or two tiers. Cookie Preferences. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. 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.
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