You should collect the member’s copayment, coinsurance and/or deductible for covered services and submit all clean claims for covered services to us for payment. MA, MD, ME, MI, MN, MO, MT, NE, Payer ID — 60054 Doing Business As: AETNA BETTER HEALTH OF KENTUCKY. El Paso, TX 79998-1106. •Avoid the additional cost of submitting duplicate claims by using the Claim Status Inquiry to check the status of claims prior to resubmitting. . Medical Billing Question and Answer – Terms, EVALUATION AND MANAGEMENT CPT code [99201-99499] – Full List, Internal Medical Billing Audit – how to do, CPT 93922, 93923, 93924, 93925- BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES. PO Box 14079 These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. Multiple bills for each family member can be submitted with one claim form. Aetna Better Health PO Box 60938. A vaccine provider enrollment checklist is provided with instructions for enrollment. caregivers, and former foster care youth can contact Aetna Better Health of Kentucky's Member Services team at 1-855-300-5528 (TTY: 711) or access the Aetna website to make sure their provider is included in the network. The following information regarding the scope of practice of this provider is available: NPI stands for National Provider Identifier. We pay $25.04. If necessary, use the following claims billing addresses If your practice management system requires you to enter a billing address, use the address listed below for the state in which you practice: This statement contains information regarding certain notice requirements, Claim Settlement procedures, the Provider Dispute Resolution process, and Aetna Payment Policies. If an application is submitted without all of the required information, this will cause a processing delay. Before implement anything please do your own research. Coventry Cares/Aetna Better Health Humana - CareSource . Phone: 502-852-6901 | Fax: 502-852-6056 View Map 1107 CROWN POINTE DR STE 107 ELIZABETHTOWN, KY 42701-7280 • ID card — “Medicare PPO” is indicated in the upper corner of the ID card (see the example on page 2). The 1306223524 NPI number is assigned to the healthcare provider AETNA BETTER HEALTH OF KENTUCKY INSURANCE COMPANY, practice location address at 9900 CORPORATE CAMPUS DR STE. Medicaid is offered at no or very low costs for those who qualify. Insurance Denial Claim Appeal Guidelines. You can visit www.aetnaeducation.com for easy access to training and resources related to MA plans. – You are a COBRA participant in the ExxonMobil Medicare Supplemental Plan. •Enter the member ID number exactly as it appears on the ID card. If you have questions or concerns about your health insurance coverage, we'd love to hear from you. If you have any questions, please contact our Provider Service Center at the following: The Aetna Better Health® of Kentucky "Memories are far more indelible when married to the physical world, and Spitznagel proves the point in this vivid book. Aetna coresource claims address and Phone Number. If you are eligible for both Medicare and Medicaid, you may be eligible for an Aetna ® Dual Special Needs Plan (D-SNP), including a personal care team, at low or no cost. Humana Healthy Horizons in Kentucky (800) 444-9137. •For questions on how to submit electronic claims to third-party administrators, such as an individual practice association, contact the third-party administrator. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. . Found inside – Page 29A lower number means a better accreditation . ... NonName formulary Getting care quickly Generic Customer service Claims processing Plan name Indiana Advantage Health Plan , Inc. $ 15 $ 30 $ 400 $ 10 $ 30 $ 50 O Aetna Health Inc. $ 20 ... We'll match you to new patients based on your clinical specialty and insurance panel, at no cost to you. RE: CCRConcurrent Review Fax Number Update Kentucky Quit Now Program Updates Demographic Update Form 1. Remember to include the patient-paid amount on claims and encounters submitted to us. The provider's business location address is: 9900 CORPORATE CAMPUS DR STE. Boston, MA 02215-0014 The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model. Kentucky Medicaid, but billing procedures and coverage of some services may differ. All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. In all cases, the patient or authorized person must sign. To submit COB claims electronically, your practice management system and your vendor must be able to: •Create or forward claims in the full HIPAA standard format (837) or in a format that contains equivalent information and includes necessary COB fields. Coventry (Including workers compensation and auto injury) 800-937-6824. Provider Enrollment Provider Services (877) 838-5085 (M-F, 10:00 AM - 4:30 PM ET) Member Services . Affordable HealthChoices from Aetna®, SRC, an Aetna company MOB provision: $370 bill results in $65.70 Aetna normal benefit. . Fax Number: Passport Health Plan by Molina Healthcare (844) 778-2700. ABHWV Provider Manual 2020-2021 FINAL 12-20 - Aetna. If you are having difficulties registering please . • Provide the name, Member ID number or Social Security number, address and phone number of the covered person. Make sure the following items are included on all applications: • Beneficiary’s name, as shown on their Medicare card, • Beneficiary’s permanent residence address/physical street address (PO box is not acceptable), • Medicare HICN — this is the number on the beneficiary’s Medicare card, • Proof of Medicare Part A and/or B entitlement, • On all 2018 applications, your National Producer Number (NPN)*. Our plans go by different names in different states, but they all offer the same high-quality care. D. Your signature is required to complete this form. This section relates to information about the covered person. The provider is registered as an organization entity type. Aetna Better Health is not responsible or liable for non-Aetna Better Health content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Please help ensure your clients don’t miss this critical step! • No contract is required to see members enrolled in these plans. Authorizations. Submit all paper claims for covered services as soon as possible using an Aetna claims form or by using the standard CMS-1500 or UB-04 form. Finding correct claim submission address based on state. Part of the Neurosurgery by Example series, this volume on neurotrauma presents exemplary cases in which renowned authors guide readers through the assessment and planning, decision making, surgical procedure, after care, and complication ... • Indicate which type of covered person you are. Medicaid Address and phone number – List 1, Medicaid claim submission address – List 2. Designed by Elegant Themes | Powered by WordPress, CPT 59400, 59409, 59410 – Routine obstetric care including antepartum care, vaginal delivery, CPT 98966, 98967, 98968 – Telephone assessment, CRISIS STABILIZATION SERVICES Billing and Coverage LIMITATIONS, CPT CODE 64493 -Paravertebral Facet Joint Injection, CPT 97597, 97598 Removal of devitalized tissue from wound care, CPT Code 99201, 99202, 99203, 99204, 99205 – Which code to USE. During that time, you'll be able to access both portals. Payer ID — 60054, PO BOX 569000 Phoenix, AZ 85040. Provider External Independent Third-Party Review In accordance with 907 KAR 17:035, if you receive an adverse final decision of a denial, in whole or in part, of a health service or claim for reimbursement related to this service, you may request an external independent third-party review. AETNA BETTER HEALTH® AETNA BETTER HEALTH® KIDS Practitioner information change Make sure your contact information is current with us. ND, NH, NJ, NY, OH, OK, PA, RI, SD, If necessary, use the following claims billing addresses. Log in. The web portal provides online access to prescription and Kentucky specific plan information as well as supporting documentation. Aetna Medicare Advantage PlanU Aetna Better Health of West Virginia. Found inside – Page 556The state chose to contract with three managed care plans: Aetna Better Health of Kentucky (owned by Aetna), Wellcare of Kentucky ... The autoassignment algorithm took into account prior physician relationships, family relationships, ... Get more from Medicare & Medicaid. 100% allowable COB: $370 bill results in $0 primary carrier payment and $25.04 patient responsibility per primary carrier. • Aetna Better Health of KY at 1-855-300-5528 • United Health Care at 1-866-633-4449 1.2.2.3 KCHIP The Kentucky Children's Health Insurance Program (KCHIP) provides coverage to children through age 18 who have no insurance and whose household income meets program guidelines. We manage plans across the country including the Children's Health Insurance Plan (CHIP), plans for people on Medicaid and Medicare and long-term care programs. Access member resources, form downloads and more. Learn more about the benefits and support programs included in your Aetna medical insurance plan that provide coverage to help you get effective treatment so you can feel your best. LEXINGTON KY 40512 800-548-3945, P O BOX 14089 Found inside – Page 35A lower number means a better accreditation . ... day x 3 $ 10 $ 20 / $ 45 Yes 0 Vantage Health Plan $ 15 / $ 15 $ 250 $ 10 $ 20 / $ 35 Yes Maryland Aetna Health Inc. - High $ 15 / $ 20 $ 150 / day x 3 $ 10 $ 25 / $ 40 No O O 0 O 0 . Do not include any dashes, suffixes or spaces. We want to hear from you. CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NE, ND, NH, NJ, NY, OH, OK, PA, RI, SD, TX, VA, VT, WI, WV, WY, Address 8 1-855-336-6054 Behavioral Health/Psych Testing 1-888-604-6106 1-855-301-1564 Dental (Avesis) 1-855-214-6776 Medicaid is offered at no or very low costs for those who qualify. El Paso, TX Infinedi that a common reason for rejections is the use of an expired provider state license number in the paperwork. decision should call the phone number listed in the denial letter, 1-888-470-0550, within five (5) business days of the verbal notification of the denial decision. For Medicare HMO plans only: 1-800-624-0756; For all other plans (PPO and Commercial HMO plans): 1-888 MD-Aetna (632-3862); Or visit the Aetna website at www.aetna.com. no deductible), no paperwork (i.e. Aetna Better Health® of Kentucky 9900 Corporate Campus Drive, Suite 1000 Louisville, KY 40223 PO Box 981106 Here's information on how to file a member complaint, grievance or appeal. Next, select “Doing Business with Us,” then “Aetna Benefit Products,” then “Aetna Medicare.” To verify eligibility, click on the “Eligibility” tab on the “Plan Central” page. Aetna Medicaid affiliates currently own administer or support • These members will have an Aetna Medicare (PPO) ID card — like the one you see on page 2. We have over 30 years of experience serving Medicaid populations, including children, adults and people with disabilities or other serious health conditions. PO Box 14020 Aetna CareUnify is a Population Health Management system for healthcare providers and health plan resources to connect and manage patients' continuity of care through multiple care settings. The provider performing the postpartum visit must complete the Promise Rewards form and return it to Aetna Better Health of . • Submit a separate claim form for each eligible family member. PO Box 14079 CCR Fax Number is 1-855-454-5043 Please check all documents at your facilities containing the Aetna Better Health of Kentucky Concurrent Review (CCR) fax number to ensure you are using the correct fax number. Paper claims submission They serve approximately 22.1 million medical members. Aetna We’ll contact you if we need additional documentation. But for those enrolling in an HMO plan, this is especially important. Lexington, KY 40512, P O BOX 981109 EL PASO TX 79998-1109 800-777-3240, PO BOX 981107 EL PASO TX 79998-1107 800-245-1206, Aetna B,M ,W 888-632-3862 1-866-604-7092, Aetna Medicare Prescription Drug Plan Found inside – Page 19The following are examples of six plans that have implemented transparency tools to help their enrollees become better informed health care consumers . Aetna has developed a suite of tools , called Estimate the Cost of Care ... DEPARTMENT PHONE FAX Email General Number 1 -800 -578 -0636 1 -502 -585 -7989 About Aetna Better Health of Louisiana Aetna Medicaid has been a leader in Medicaid managed care since 1986 and currently serves almost 3 million individuals in 16 states. Provider Portal. As a valued Aetna member, you have the right to make your voice heard about your health care experience - whether it's about us, your plan, a health service or provider. Get Aetna Better Health of Kentucky reviews, ratings, business hours, phone numbers, and directions. Aetna Better Health of Kentucky - (855) 300-5528 Anthem Blue Cross Blue Shield - (855) 690-7784 United Healthcare Community Plan (866) 293-1796. (Dec. 30, 2020) - All Kentucky Department for Medicaid Services providers seeking to receive and administer the COVID-19 vaccine must enroll with the Kentucky Department for Public Health (KDPH) as soon as possible at vaccine provider enrollment. Aetna Medicare Grivance submission address. The link to NCCI on the Centers for Medicare & Medicaid Services (CMS) website is www.cms.gov/nationalcorrectcodinited/. Concurrent Review and Retro Fax Numbers As a reminder, the Aetna Better Health of Kentucky Concurrent Review (CCR) and Retro fax numbers are listed below: CCR - 1-855-454-5043 Retro - 1-855-336-6054 Please do not hesitate to contact us if you have any questions, Customer Service can be reached at 1-855-300-5528. Jonathan Copley is serving as Chief Executive Officer, Aetna Better Health of Kentucky, Aetna Medicaid in the Aetna Inc is an active company headquartered in Hartford, CT in the states of CT.The Aetna Inc office address is located at 151 Farmington Ave, Hartford, CT, 06156, United States.The company comes under Biotech/Healthcare->Healthcare Facilities/Services industries. The authorized official title is Vice President And Secretary and has the following contact phone number (860) 273-1051. The enumeration date for this NPI number is 4/27/2015 and was last updated on 4/27/2015. A free online platform to help grow your practice. Claims Inquiries – To confirm the recorded date of claims receipt or to make other inquiries about claims, you may call Aetna at 1-800-624-0756 for Medicare HMO Products / 1-888-MD-Aetna (632-3862) for All Other Products, or contact your clearinghouse vendor. Aetna Better Health is not responsible or liable for non-Aetna Better Health content accuracy or privacy practices of linked sites or for products or services described on these sites. Aetna Better Health of Kentucky (855) 300-5528 Anthem Blue Cross Blue Shield (855) 690-7784 Payer ID — 57604, Requirements to submit Coordination of Benefits (COB) claims electronically. We encourage you to take advantage of this easy-to-use feature. Electronic claims submission Use our electronic payer ID #60054. The provider's business location address is: 9900 CORPORATE CAMPUS DR STE. As a result, you are likely to see more patients with these health plans. Aetna Better Health of Kentucky. Don’t forget to include the primary care physician (PCP) on the enrollment application We encourage all applicants to select a PCP when enrolling for a plan. Children with KCHIP III are eligible for all Medicaid-covered . Mental health conditions like anxiety or depression can affect anyone at any time. Resources, policies and procedures at your fingertips. For Medicare Products Provider Dispute Inquiries HMO plans only: Contact the Provider Service Center at 1-800-624-0756. 4. Updated: 7/01/2021 #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. Aetna Better Health of Kentucky is located at 9900 Corporate Campus Dr #1000, Louisville, KY 40223. 2021 Provider Manual . 68069. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. Phone. Fax: 866-996-0077. Reimbursement and claims processing information. Special notice for providers not accepting new patients: What to do if you’re contacted by a member or potential member If you’re not accepting new patients, but are contacted by a member or a potential member who wants to become a new patient, you must tell them to contact: ** The California Department of Managed Health Care at 1-888-466-2219, or the California Department of. • Precertification is recommended, but not required. 1. Found inside – Page 105Blue Cross and Blue Shield continued to collaborate with federal and state governments in providing healthcare benefits ... capital to better compete with commercial insurance companies, such as Aetna, Cigna, and the UnitedHealth Group. Please contact the myNEXUS provider network team with any questions at provider_network@myNEXUScare.com. Pharmacy. Where to turn for help Depending on your situation, you have a variety of resources to help you find the answers you’re looking for: Find a Medicaid provider today with Aetna Better Health of Kentucky, formerly CoventryCares of Kentucky. Find a Medicaid provider today with Aetna Better Health of Kentucky, formerly CoventryCares of Kentucky. The book provides background on selected notable alumni and their contributions to the Commonwealth and the world. 1441 Main Street, Suite 900, Columbia, SC 29201. More online tools and resources available at www.aetna.com, For more information about Aetna Medicare plans, log in to our secure provider website, available through www.aetna.com. El Paso, TX Medicare limiting charges apply. SEE IF YOU QUALIFY. Infinedi found there is an increase in claim rejections from Kentucky Medicaid and its associated MCOs: Caresource, Anthem KYMD, Aetna Better Health, Wellcare and Passport, for service dates of May 1, 2016, forward. ABHWV has two separate contracts with DHHR. Aetna meritain claims address and Phone number. Behavioral Health 1-888-604-6106 1-855-301-1564 Mountain Health Trust Contract • Can be chosen for regular Medicaid The result can be a higher payment than what a provider would see with 100% allowable coordination of benefits. You can even print your chat history to reference later! MIAMI FL 33256 800-452-8633, P O BOX 14079 In Kentucky, DME service providers must be licensed with the Kentucky DME Suppliers; Enrolled as an active Medicaid provider and, if applicable, enrolled with the managed care organization (MCO) of any beneficiary it serves. If you want to make changes to your information, all you have to do is fill out the form on page 2. Aetna Provider Phone Number for below plans - 800-624-0756. This book focuses on three of the main categories of myeloproliferative neoplasm: polycythemia vera, essential thrombocythemia, and primary myelofibrosis. Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. Mail. Our plans go by different names in different states, but they all offer the same high-quality care. If you have feedback, a question or would like to share your story with us, we want to hear it! This guide helps people with Medicare understand Medigap (also called Medicare Supplement Insurance) policies. A Medigap policy is a type of private insurance that helps you pay for some of the costs that Original Medicare doesn't cover. Claims Address. 79998-1106, Aetna Student HealthSM Aetna Better Health ® of Kentucky . The provider is (1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. All Rights Reserved to AMA. Found inside – Page 52In January , for example , the Wall Street Journal reported that the Aetna Foundation had formed a $ 15 million Quality Care Research Fund to sponsor applied research that will directly improve health outcomes for patients . Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe ... Given the strong current attention of orthopaedic, biomechanical, and biomedical engineering research on translational capabilities for the diagnosis, prevention, and treatment of clinical disease states, the need for reviews of the state ... LEXINGTON KY 40512-4586 888-632-3862, PO BOX 23759 Today, more than 225,000 children in 13 states receive high-intensity behavioral health programming and wraparound Escalations. Mental Health Providers - Quartet Health. Click Become An Agent if you are interested in taking advantage of our sales opportunities HEALTH CARE PROFESSIONALS, PHYSICIANS, PROVIDERS AL, AK, AR, AZ, CA, FL, GA, HI, ID, 800-238-6279. Aetna Inc. is a managed health care company that was founded in 1853. Aetna Better Health of Kentucky can be contacted at (502) 622-7577. We will response ASAP. Fax Anthem BCBS Medicaid 1-855 -661 2028 502 212 7336 CoventryCares/Aetna Better Health ; 1-855-300-5528 Box 14079 • We will pay Medicare-allowable rates to you for clean claims for covered services, less the member copayment, coinsurance and/or deductible, as described and required under MA regulations and the member’s MA PPO plan. Aetna Better Health of California Opens In New Window. This type of complaint does not involve coverage or payment determinations. Found inside – Page 21A lower number means a better accreditation . Enrollee Survey Results above average , O average , O below average Prescription Primary Hospital drugs care per doctor stay office deductible / Brand Noncopay copay Generic Name formulary ... Access member resources, form downloads and more. Aetna Medicare Grievance & Appeals Links to various Aetna Better Health and non-Aetna Better Health sites are provided for your convenience. Please see contact list below. Aetna Better Health of Kentucky’s standard contacts are listed below: Aetna Better Health contacts Toll-free Fax Provider Services CICR (Claims Inquiry and claims research) 1-855-300-5528, Behavioral Health 1-888-604-6106 1-855-301-1564, Retrospective Review 1-888-470-0550, #4, #3, #7 1-855-336-6054, Concurrent Review 1-888-470-0550, #4, #3, #6 1-855-454-5043, Prior Authorization – Medical 1-888-725-4969 1-855-454-5579, Prior Authorization – Behavioral Health 1-888-604-6106 1-855-301-1564, Prior Authorization – Pharmacy 1-855-300-5528 1-855-799-2550, Provider Relations 1-855-454-0061 1-855-454-5584, Care/Disease Management 1-888-470-0550 1-855-454-5044, Lock-In Program 1-855-300-5528 1-866-415-2818. LEXINGTON KY 40512-4100 800-424-4047, PO BOX 14586 Aetna Better Health of Kentucky: Member Services: (855) 300-5528 TTY users: 711 TDD users: (800) 627-4702 ; Anthem Member Services: (855) 690-7784 TTY and TDD users: 711 ; Humana Loaded with concrete meditation exercises, behavioral techniques, nutrition advice, and meal-planning charts, this book provides the tools to manage cravings, curb emotional overeating, and figure out when you are full. Work with referring providers to treat patients' total health: mind . BE SURE TO KEEP COPIES OF CLAIMS SUBMITTED FOR YOUR FILES, MAIL CLAIMS TO: The text discusses employer-employee relationship, elements of a case, work-relatedness, disability and death, medical and income benefits, third party actions, and more. Live-agent chat is the easiest and fastest way to get real-time support for an array of topics, including: Member Eligibility. Aetna Better Health of Virginia - HMO SNP. Phoenix, AZ 85082. AETNA BETTER HEALTH OF KENTUCKY INSURANCE COMPANY is a health maintenance organization in Louisville, KY. Aetna Better Health Of Kentucky: Anthem Blue Cross And Blue Shield Medicaid: Humana Health Plan, Inc. Passport Health Plan: Passport Health Plan By Molina Healthcare: Unitedhealthcare Community Plan Of Kentucky: Wellcare Of Kentucky, Inc. Contact Information Division of Program Integrity. Please visit your health plan website for the plan-specific phone number. •All providers, both participating and nonparticipating, can submit claims electronically regardless of patient’s benefits plan. Lexington, KY 40512-4079, State Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. The Provider Service Center helps with contracting, patient services, precertification and many other questions. • Simplified billing — submit one bill to Aetna and receive one remittance. Mail to: If payment is to be made DIRECTLY to the service provider (such as a doctor or hospital), also sign this block. Found inside – Page 566Some plans classify participating providers into tiers by their performance on various cost and quality measures. When patients select providers who are designated as better performers by the plan, the patient is charged a smaller ... Aetna serves as the sole statewide coordinator of physical and behavioral health, dental care, and social services for approximately 28,000 children and youth in Kentucky's child welfare and juvenile justice systems. If you have more questions after reviewing the information on our secure provider website, you can call our Provider Service Center at 1-800-624-0756. PO Box 15708 AL, AK, AR, AZ, CA, FL, GA, HI, ID, LA, MS, NC, NM, NV, OR, SC, UT, TN, WA, State Aetna Owned Health PlansAetna Better Health of CaliforniaAetna Better Health of FloridaAetna Better Health of IllinoisAetna Better Health of KansasAetna Better Health of KentuckyAetna Better Health of LouisianaAetna Better Health of MarylandAetna Better Health of MichiganAetna Better Health of New JerseyAetna Better Health of New YorkAetna Better Health of OhioAetna Better Health of PennsylvaniaAetna Better Health of TexasAetna Better Health of VirginiaAetna Better Health of Virginia - HMO SNPAetna Better Health of West Virginia, Aetna Administered Health PlansMercy CareParkland Community Health Plan.
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