The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. If its not there, check the back of the card. 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. 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. Question: How To Read Aetna Health Insurance Card. The insurance company uses this number to identify your employers health insurance policy. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. WebThe member can activate their card by calling the number on their activation sticker. CPT only copyright 2015 American Medical Association. Your subscriber ID number is an ID number assigned by your employer or Delta Dental. Some individuals may have a single insurance card that covers both medical expenditures (such as visits to the doctor or hospital) and pharmacy benefits (to pay prescriptions), although these are often two distinct cards with unique identifying numbers. If you are an Aetna member with questions about your coverage, please refer to our Member Services page for login information and additional ways to contact us. Medicaid cards vary by state and do not contain RxGroup, RxPCN, or RxBIN numbers; only a Member ID number is included. Note that the gold Medicaid card has simply the Member ID, but the managed care plan includes the Member ID, RxBIN, RxPCN, and RxGroup numbers. For language services, please call the number on your member ID card and request an operator. In seconds, it will get you to the right person to help you. Links to various non-Aetna sites are provided for your convenience only. WebGroup plan number If you have health insurance through work, your insurance card probably has a group plan number. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. All Rights Reserved. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. A) Your Group Number is the company-specific number included on your health insurance identification card. All Rights Reserved. Others have four tiers, three tiers or two tiers. Always provide your Member ID Card while visiting a medical institution or doctor. In case of a conflict between your plan documents and this information, the plan documents will govern. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Not all insurance cards have a group plan number. 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. For your convenience, we recommend that you add your Member Services number to your phone contacts. 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. INSURANCE. Total Benefit Solutions (Aetna International), Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871, Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871, Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Your PCP can be altered at any time. The number appears on the back of your Aetna identification card. The policy number is usually located on the front of the card, near the top. Members can go to www.Aetna.com and Log into your account. It should be labeled as a policy number. If there are any questions, your insurance provider will be happy to help. You may get a discount if you use a NAP doctor. How much is mavyret pricing disclosure outside insurance? Health benefits and health insurance plans contain exclusions and limitations. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. 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. What if I am unable to locate the RxBIN, RxPCN, or RxGroup on the card? Check the back of your card first, as it is not usually on the front! There is no option for members to get information at this number. Disclaimer of Warranties and Liabilities. Aetna cards, for instance, may have merely a Member ID number and a RxBIN number. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Tweet with us 8 AM to 8 PM ET Monday through Friday @Aetna and 24/7 @Aetna Help. Employers can also locate the company's group number on If you cant find your insurance card, dont Preview / Show more . What is the name of the policyholder? Where is my policy number on my insurance card? 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. Visit the secure website, available through www.aetna.com, for more information. Which type of insurance is probably the most neglected form of available insurance protection? You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. Each employer that buys a health plan for its employees also has a number. Click on View Member ID, on the left side of page under family/plans. How much for a tooth extraction without insurance? In most cases, your number will appear on your ID card. Some subtypes have five tiers of coverage. WebThe member can activate their card by calling the number on their activation sticker. Please select Member ID to continue. As the proprietor of an independent insurance agency, you will enjoy complete independence. The policy number is usually located on the front of the card, near the top. The best place to find details about your coverage and benefits is your secure member website. 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). Example: W123456789. 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). 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. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. How long after an accident will insurance go down? To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, Coventry Health and Life Insurance Company and their affiliates (Aetna). This information is neither an offer of coverage nor medical advice. You are now being directed to CVS Caremark site. Is my insurance policy number the same as my ID number? What policy number is shown on an Aetna insurance card? 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. While ID cards vary according to the health plan that designs them, the group number is a vital piece of information that should be included. Is the digital Aetna ID card same to the physical card? Insurance company contact information Treating providers are solely responsible for medical advice and treatment of members. Aetna Inc. 151 Farmington Avenue. 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. 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. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. This search will use the five-tier subtype. If you have just Original Medicare, you do not have a group number; nonetheless, your 11-digit Medicare number is printed on your red, white, and blue Medicare card. 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. Webnumber is listed on the back of your Aetna ID card. RxPCN, which stands for Processor Control Number, is another unique identification the pharmacy uses to identify you. Medicare has also chastised Aetna for nearly $12 million in Medicare overpayments in 2007 and 2009. Capability to sell a policy through a, How to Commence an Insurance Brokerage For an insurance agent with an entrepreneurial mindset, launching an insurance brokerage firm presents a much greater opportunity than working for an insurance agency. 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. 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. 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). Member ID/Policy Number. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. 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. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. Is my policy number my account number? How much does accutane cost with insurance? If its not there, check the back of the card. If youre the policyholder, the last two digits in your number might be 00, while dependents might have numbers ending in 01, 02, etc. What is the policy number on a health insurance card? The number is always on the front of the card. Our voice prompt service offers a choice of options for everyday questions. Member ID and RxBIN are the two most critical pieces of information required for the pharmacy to locate your health insurance coverage. Using the Aetna Navigator, you may obtain your digital card. The group number on the insurance card identifies the employer that purchased a particular health insurance plan. That number is 1-877-261-9951 (TTY:711) . member identification number and group number Your physician will utilize this number for. What does an Aetna subscriber ID signify? 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. What are RxBIN and RxPCN, and what are their functions? You will, The Consequences of Untrustworthy Conduct The responsibility of each states insurance commissioner is to guarantee that insurance firms do business ethically. 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). Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. See all of the ways you can contact us Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Some subtypes have five tiers of coverage. If you cant find your insurance card, dont Preview / Show more . 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