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). What policy number is shown on an Aetna insurance card? WebYour full legal name as it appears on your Medicare ID card; Your Social Security number (even if you receive benefits through your spouse) Your address and contact info, including your phone number or email address; You may also be Box 7012 Downey, CA 90242, Rx PCN for MMA: NCCMS Rx PCN for HDHP: NCHDP Rx PCN for HMO: 70000, HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11172 Rx Group: SC Tax ID: 94-1340523 COB Address P.O. What is the insurance number on a card issued by Aetna Insurance? Go to the American Medical Association Web site. USA. WebYou can find your member ID number on your member ID card. RxPCN, which stands for Processor Control Number, is another unique identification the pharmacy uses to identify you. Your benefits plan determines coverage. You may get a discount if you use a NAP doctor. If its not there, you may need to call the customer service number, but you also just might not have one if youre not receiving your coverage through your employer. CPT only Copyright 2022 American Medical Association. Not all insurance cards have a group plan number. If you are the policyholder, the last two digits in your number might be 00, while others on the policy might have numbers ending with numeric characters like 01,02, etc. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. How to become a property and casualty insurance broker? It takes only a few minutes to register. Our voice prompt service offers a choice of options for everyday questions. Applicable FARS/DFARS apply. In seconds, it will get you to the right person to help you. Please ensure that the identification number and date of birth you submit are identical to those on file with the George Washington University. The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. If you are the policyholder, the final two digits of your policy number may be 00, but other policyholders numbers may end in 01, 02, etc. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. For language services, please call the number on your member ID card and request an operator. Every health insurance card must have a policy number. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. What does subscriber ID mean? While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. The member name is the name of the person who is covered under the insurance plan. This information is neither an offer of coverage nor medical advice. Understanding your card can help you plan your healthcare expenses and get the care you need. Find your Member ID on your ID card, Welcome Letter, or any EOB you received from us. Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. How to report a disability insurance company for bad faith? Visit the secure website, available through www.aetna.com, for more information. What is subscriber number on insurance card Aetna? 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. Our voice prompt service offers a choice of options for everyday questions. ", The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. If you only have Original Medicare, you dont have a group number, but your 11-digit Medicare number is on your red, white and blue Medicare card. The expense might not All services deemed "never effective" are excluded from coverage. The AMA is a third party beneficiary to this Agreement. Medicaid offers free or low-cost health care to millions of Americans, including low-income individuals, families and children, pregnant women, and those with disabilities. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. After thirty days, several states compel Medicaid beneficiaries to transfer to a managed care plan. The majority of pharmacy cards will have all four numbers (Member ID, RxGroup, RxPCN, and RxBIN), although there are a few plans that do not include all four digits but are still approved. To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. The policy number is usually located on the front of the card, near the top. For your convenience, we recommend that you add your Member Services number to your phone contacts. 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. It is doubtful that your group health insurance number will appear on the back of your card, as the cards front contains all of the most significant information. Copyright 2015 by the American Society of Addiction Medicine. WebCall us. So if you purchased your insurance through the Healthcare Market or have a government-based plan such as Medicare, you may not see a group 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. It helps identify you and your policy, similar to a bank account number. The corporate headquarters phone lines are staffed Monday through Friday, 8 AM to 6 PM ET. member identification number and group number Your physician will utilize this number for. It is only a partial, general description of plan or program benefits and does not constitute a contract. They do not have access to member accounts but they can provide Aetna Member Services contact information. Medicaid cards vary by state and do not contain RxGroup, RxPCN, or RxBIN numbers; only a Member ID number is included. Applicable FARS/DFARS apply. The policy number is usually located on the front of the card, near the top. What is the GRP acronym? 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). It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. WebThe member can activate their card by calling the number on their activation sticker. 1-800-US-AETNA (1-800-872-3862) (TTY: 711) between 8:00 AM and 6:00 PM ET. Just enter your mobile number and well text you a link to download the Aetna Health app from the App Store or on Google Play. If you cant find your insurance card, dont Preview / Show more . Need help finding your Member ID? Lets say your health insurance plans allowed amount for an office visit is $100 and your coinsurance is 20%. You use it when you visit the doctor, hospital or other provider. 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. We want to make it easier for you to live healthier. These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. New and revised codes are added to the CPBs as they are updated. In case of a conflict between your plan documents and this information, the plan documents will govern. Please note also that the ABA Medical Necessity Guidemay be updated and are, therefore, subject to change. Contact us if you are experiencing problems, and we will assist you. We want to make it easier for you to live healthier. What is my Aetna ID number? If you cant find your insurance card, dont Preview / Show more . It offers coverage for wind and hail in the legislatively defined, Independent Agents are fully unaffiliated with a parent firm. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Member ID/Policy Number. The number is always on the front of the card. The majority of pharmacy cards will have all four numbers (Member ID, RxGroup, RxPCN, and RxBIN), although there are a few plans that do not include all four digits but are still approved. The member's benefit plan determines coverage. 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. The expense might not 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. There is no option for members to get information at this number. For example, if you have health insurance through your spouses health insurance plan, he or she is the primary subscriber. Applicable FARS/DFARS apply. CPT is a registered trademark of the American Medical Association. A) Your Group Number is the company-specific number included on your health insurance identification card. Checking the status of a claim. This is also called your Subscriber ID number, and you can find it on your Health Net insurance card. That number is 1-877-261-9951 (TTY:711) . In case of a conflict between your plan documents and this information, the plan documents will govern. This is the phone number for the Corporate Contact Center. You might look at your Medicare card and wonder Different Insurance Cards There are several sorts of insurance cards used in a variety of situations, and this article will help you locate the necessary insurance information. All Rights Reserved. You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. 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. WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). Which type of insurance is probably the most neglected form of available insurance protection? 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. Everyone covered by your companys insurance will have the same group number. If its not there, you may need to call the customer service number, but you also just might not have one if youre not receiving your coverage through your employer. Type of outofarea coverage Plan Code: See page 2 for plan code information. You can also provide this number to your health insurance company so they can look up your information when you have questions about your benefits and any recent claims. How to start a insurance broker business? 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. In 2020, the average national cost for health insurance is $456 for an individual and $1,152 for a family per month. Your Medicare group number must appear on your Medicare Advantage, Medicare Supplement, or Part D insurance card. Your benefits plan determines coverage. 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. INSURANCE. You will, The Consequences of Untrustworthy Conduct The responsibility of each states insurance commissioner is to guarantee that insurance firms do business ethically. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. Do you want to continue? During this brief transition period, your clients may be able to utilize this information, if necessary, to acquire prescriptions. In this case, members may utilize their plans Rx BIN and PCN numbers to access pharmacy benefits while they wait for their new health plan ID cards. 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