However, . The member's benefit plan determines coverage. 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. 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 Rights Reserved. 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. Members should discuss any matters related to their coverage or condition with their treating provider. Your patients health and your ability to access their information is important to us. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Copyright 2015 by the American Society of Addiction Medicine. Learn more about our clearinghouse vendors here. Call center hours 24 hours, 7 days. Sutter Health is a registered Credentialing involves collecting and , Health WebWelcome to Meritain Health's Aetna DocFind site. 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). 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. 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. 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. They go above and, Trusted Advisors Since 1984. Please contact your Meritain Health Representative. 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. Past Week 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. 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. Our trusted partnership will afford you and your practice a healthy Detail: Visit URL Category: Health View Health 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. All Rights Reserved. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. Doctors who accept Meritain Health Insurance | Doctor.com Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Clicking this button will cancel username recovery and navigate to login page Clicking this button will navigate to the next page Continue This means we can connect you to over 700,000 providers , Health WebThe three primary phases of provider credentialing are as follows: 1. 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. Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone I may or may not be employed by an Aetna-contracted provider. After-hours, weekend and holiday services. Provider services - Meritain Health 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. 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. Do you want to continue? When youre caring for a Meritain Health member, were glad to work with you to ensure they receive the very best. For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination Request a medical application Request Part D pharmacy participation Request participation in First Health Submit feedback Find frequently asked questions (FAQs) Find more options under: 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). The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Aetna Claim Address|Aetna Provider Phone Number Updated (2023) Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The AMA is a third party beneficiary to this Agreement. I practice independently and I want to contract with Aetna. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. 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 subtypes have five tiers of coverage. Links to various non-Aetna sites are provided for your convenience only. Cloudflare Ray ID: 7c0ab7761d84efce PLEASE NOTE: The Precertification Request form is for provider use only. Applicable FARS/DFARS apply. For a faster response, please call us directly at 888-666-8135. Independent retail pharmacies can fill out the form at the link below. Meritain 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. Your online Meritain Health provider portal gives you instant, online access to patient eligibility, claims information, forms and more. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. The Aetna Service Centers help with benefits, claims, appeals, contracted rates, and many other questions. If youre still not sure which providers are in your network, dont worry! We are excited to share that MeridianCare, a WellCare company, is , Health (Just Now) WebEnsure that the details you fill in Meritain Benefit Enrollment Form Fillable is up-to-date and correct. 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. Aaron Lissarrague - American Family Insurance, Our American Family Insurance agency is committed to inspiring and protecting dreams, Welcome to the Roderick Youngdahl agency, serving the Maple Grove, MN area since, **You can drop off the information at Debbie's Tax Facts located in Maple Grove, MN, Becky Meierhofer - State Farm Insurance Agent, Thank you for considering Meierhofer Becky Ins. This Agreement will terminate upon notice if you violate its terms. Navigate phone maze to a human Press 2, 0#, 0#, and 0# and you will be transferred. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. Click , https://corp.mhplan.com/en/provider/michigan/meridianhealthplan/join/, Health (9 days ago) WebThe medical practitioners are required to login to the CAQH page to complete and activate the registration process. In 2020, we turned around 95.6 percent of claims within 10 business days. Meritain Health Provider Services - Meritain Health 1000 or toll free 7) 232-3863 ext. Include the date to the template using the Date feature. MERITAIN HEALTH - 117 Reviews - Minneapolis, Minnesota - Yelp Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. You are now being directed to the CVS Health 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. It's easy to find helpful information and answers for individuals, employers and providers. Health (3 , Health WebWelcome to Meritain Health At Meritain Health, we create unrivaled connections. 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. Have questions or need to connect with us? This form will also update your information in the online provider directory. The action you just performed triggered the security solution. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. 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. Were a proud subsidiary of Aetna and CVS Health . 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. 1000 MO IL KS Essence Healthcare Essence Healthcare 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. 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. Health. Your browser doesn't support JavaScript code, or you have disabled JavaScript. At this time, only PPO , Maryland licensed environmental health specialist, Mesa county health department grand junction, Behavioral health park nicollet st louis park, Missouri department of behavioral health, Community health network medical record, 2019 Healthmoom.com. 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. Doctor.com has profiles for millions of doctors and other health providers in the United States, including those who take Meritain Health insurance. CPT only Copyright 2022 American Medical Association. 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. Welcome to Meritain Health At Meritain Health, we create unrivaled connections. 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 that providers listed in this directory may perform . 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 Insurance Provider Credentialing - The Process - DENmaar 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. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. Skip To Main Content. 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. 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) U.S. Patent & Trademark office. We're a proud subsidiary of Aetna and CVS Health . If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. 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. Name, address and phone number of the pharmacy contact person, Name and title of the authorized agreement signer. No fee schedules, basic unit, relative values or related listings are included in CPT. PDF Claims Submission and Payment - mbh-eap.com Links to various non-Aetna sites are provided for your convenience only. If you have questions about claims or benefits, were happy to help. 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. insurance, payment options, etc. Treating providers are solely responsible for medical advice and treatment of members. And when you have questions, weve got answers! An in-network provider belongs to a group of hospitals, doctors, nurses and other health care providers your health plan has contracted with. We do our best to streamline our processes so you can focus on tending to patients. An exception could be emergency care, when you might receive coverage at the in-network rate. Have other questions about your health care benefits? There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. 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. Why to Visit Doctors in Your Provider Network - Meritain Health When you stay in your network, this usually means a lower deductible, less coinsurance and fewer out-of-pocket expenses for you. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. Step 2. For language services, please call the number on your member ID card and request an operator. Past month, Health WebMeritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. 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. 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. 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. 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. 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. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. Meritain Health - health insurance for employees - self-funding - TPA When you select a Meritain Health plan, you get . Welcome to the Meritain Health benefits program. 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.) Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. 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. Contact Us | Meridian 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. Gwizdala & Associates offers tax, bookkeeping and. Please contact your Meritain Health Representative. It is only a partial, general description of plan or program benefits and does not constitute a contract. 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. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 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. All rights reserved. Login - Meritain After review, Aetna will send your provider agreement via e-mail for signature. 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. 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. The member's benefit plan determines coverage. www.meritain.com . Our trusted partnership will afford you and your practice a healthy dose of advantages. PDF Meritain Health Benefit/Claim Customer Service 1-866-808-2609 Meritain Gather Information. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. 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. Treating providers are solely responsible for medical advice and treatment of members. All rights reserved. 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. You can access the online provider portal here. If there is a discrepancy between a Clinical Policy Bulletin (CPB) 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. 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. And what if youre not sure how to find one? Privacy Policy Call-back available NO. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Copyright 2023 Sutter Health. Please log in to your secure account to get what you need. Thank you for your interest in joining our networks. So, when you visit an in-network provider, it can help ease your mind a bit. Department you're calling Customer Service. We are excited to share that MeridianCare, a WellCare company, is , https://corp.mhplan.com/en/join-our-network/, Health (Just Now) WebWelcome to Meritain Health's Aetna DocFind site. Torequest participation in First Health networks, follow the link below. Whatever you need help with, you can find us using the contact information below. 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). By continuing to use the site, you agree to the use of cookies. Were a proud subsidiary of Aetna and CVS Health . (5 days ago) WebHere's how it works: Step 1. we make it easier for you to quickly identify the most informative profiles on Doctor.com. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. Were a proud subsidiary of Aetna and CVS Health . Copyright 2023 Meritain Health. 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 . Youll benefit from our commitment to service excellence. By showing providers with higher ProfilePoints first, Clinical Update Request. Meritain Health Provider Enrollment. Reprinted with permission. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. 3. Meritain Health P.O. Need Help? For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Welcome to Meritain Health's Aetna DocFind site. 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. Past 24 Hours First, you can request participation in the Aetna network by completing our online request for participation form. (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 Provider Services - Meritain Health Provider services Contact us Your patient's health and your ability to access their information is important to us. It is a separate process from network contracting. And our payment, financial and procedural accuracy is above 99 percent. 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. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. 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).
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