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. Links to various non-Aetna sites are provided for your convenience only. When billing, you must use the most appropriate code as of the effective date of the submission. It offers coverage for wind and hail in the legislatively defined, Independent Agents are fully unaffiliated with a parent firm. Understanding your card can help you plan your healthcare expenses and get the care you need. What is a policy number? 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. 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. Gross Point of Rating. Your benefits plan determines coverage. A car insurance policy number is a unique number assigned to you by your car insurance company. Check out our post for advice on how to contact your insurance provider. An automated telephone system will answer your call. How does south carolina cover wind and hail insurance? CPT is a registered trademark of the American Medical Association. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Applicable FARS/DFARS apply. Click on "Claims," "CPT/HCPCS Coding Tool," "Clinical Policy Code Search. How much is health insurance a month for a single person? Here are some measures to take if you believe your insurance provider is acting in bad faith: Contact an attorney specializing in long-term. 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. What is the GRP acronym? WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. 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. back to FAQ listWhere can I find my Member ID number? Information on Your Health Insurance Card Insurance company name. 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. The person who pays for health insurance premiums or whose employment is the basis for membership in the insurance 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). Then, navigate to the ID card portion of your member-only website. Aetna Inc. 151 Farmington Avenue. Each employer that buys a health plan for its employees also has a number. MediExcel Health Plan is a cross-border health plan. How to become a property and casualty insurance broker? Whats the subscriber name on an insurance 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. Example: W123456789. Check the back of your card first, as it is not usually on the front! Enter your member ID without spaces or dashes. 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. For your convenience, we recommend that you add your Member Services number to your phone contacts. The percentage of costs of a covered health care service you pay (20%, for example) after youve paid your deductible. For general inquiries, reach our corporate headquarters at 1-888-US-AETNA (1-800-872-3862) (TTY: 711). Copyright 2015 by the American Society of Addiction Medicine. 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. Call the member services number on your ID card for personalized service. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. The group number on the insurance card identifies the employer that purchased a particular health insurance plan. This is the phone number for the Corporate Contact Center. 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. 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 Clinical Policy Bulletins (CPBs). It is only a partial, general description of plan or program benefits and does not constitute a contract. This number is always displayed on the cards front. Insurance company contact information If its not there, check the back of the card. Since Dental Clinical Policy Bulletins (DCPBs) 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. 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. The member should call that number to activate the card and then try to pay again. The insurance company uses this number to identify your employers health insurance policy. Gross Point of Rating. How much for a tooth extraction without insurance? WebFor general inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862) (TTY: 711). U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. Click on View Member ID, on the left side of page under family/plans. Others have four tiers, three tiers or two tiers. Aetna Inc. You can still get benefits and coverage information by calling the number on your ID card. New and revised codes are added to the CPBs as they are updated. How much is mavyret pricing disclosure outside insurance? What is my Aetna ID number? 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. See Also: Aetna insurance card policy number Show details You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. 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. Member ID/Policy Number. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. After thirty days, several states compel Medicaid beneficiaries to transfer to a managed care plan. They do not have access to member accounts but they can provide Aetna Member Services contact information. What is the insurance number on a card issued by Aetna Insurance? What is subscriber number on insurance card Aetna? Your Medicare group number must appear on your Medicare Advantage, Medicare Supplement, or Part D insurance card. 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. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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. There is no option for members to get information at this number. HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11842 Rx Group: NC Tax ID: 94-1340523 COB Address P.O. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. How to report a disability insurance company for bad faith? If you cant find your insurance card, dont Preview / Show more . 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 identification number and group number Your physician will utilize this number for. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. Each employer that buys a health plan for its employees also has a number. It takes only a few minutes to register. These numbers are located on the front of your member ID card, immediately to the left of the eligible members name. What is the GRP acronym? The ABA Medical Necessity Guidedoes not constitute medical advice. Therefore, Arizona residents, members, employers and brokers must contact Aetna directly or their employers for information regarding Aetna products and services. The insurance company uses this number to identify your employers health insurance policy. 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. Employers can also locate the company's group number on It should be labeled as a policy number. If there are any questions, your insurance provider will be happy to help. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. This is the phone number for the Corporate Contact Center. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". Your Medicare group number should be on your insurance card for your Medicare Advantage, Medicare Supplement or Part D plan. CPT only Copyright 2022 American Medical Association. This Agreement will terminate upon notice if you violate its terms. Type of outofarea coverage Plan Code: See page 2 for plan code information. If you do not intend to leave our site, close this message. It usually only appears on insurance cards that registered employers provided. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. As the proprietor of an independent insurance agency, you will enjoy complete independence. Our voice prompt service offers a choice of options for everyday questions. If you have a Medicaid managed care plan, you should still be able to get information about your pharmacy coverage. 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. However, a discount cannot be guaranteed under the NAP for any particular claim. What is the subscriber ID on an insurance card? Members can go to www.Aetna.com and Log into your account. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. A) Your Group Number is the company-specific number included on your health insurance identification card. Our phone service can help with: Answering eligibility and benefits coverage questions. The PCN (Processor Control Number) identifies the pharmacy benefit processor or Pharmacy Benefit Manager for each health plan (PBM). The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. Your PCP can be altered at any time. Gross Point of Rating. 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. 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. 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). This leads in the subsequent advantages: Freedom from onerous parent company requirements Permission to cross-sell other types of insurance Capability to compare insurers on pricing, product, and service. 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. Member ID/Policy Number. WebThe member can activate their card by calling the number on their activation sticker. 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. 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. This information is neither an offer of coverage nor medical advice. 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. An automated telephone system will answer your call. See all of the ways you can contact us If you do not intend to leave our site, close this message. What are RxBIN and RxPCN, and what are their functions? 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). The member's benefit plan determines coverage. You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. 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. And you only need your member number, which is on your Aetna ID card. 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. Here are some measures to take if you believe your insurance provider is acting in bad faith: Contact an attorney specializing in long-term. Aetna Inc. and its subsidiary 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. Reprinted with permission. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. If you cant find your insurance card, dont Preview / Show more . What is the GRP acronym? No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. This leads in the subsequent advantages: Freedom from onerous parent company requirements Permission to cross-sell other types of insurance Capability to compare insurers on pricing, product, and service. 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. 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. Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. 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). 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. Need extra assistance? Regarding the timing of the settlement check, we regret to inform you of some unfortunate news. Gross Point of Rating. INSURANCE. The American Medical Association (AMA) does not directly or indirectly practice medicine or dispense medical services. All Rights Reserved. It is only a partial, general description of plan or program benefits and does not constitute a contract. Each main plan type has more than one subtype. What is the difference between a medical insurance card and an insurance card for pharmaceutical benefits? Note: Download the Aetna Mobile App for faster, easier access to your Member ID Card. 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. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. 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. How much does accutane cost with insurance? Where Can I Find My Aetna Insurance Cards Policy Number? See all of the ways you can contact us That number is 1-877-261-9951 (TTY:711) . 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. What is the policy number on a health insurance card? You can find your Member ID on your ID card, Welcome Letter, or any EOB we sent to you. LICENSE FOR USE OF CURRENT PROCEDURAL TERMINOLOGY, FOURTH EDITION ("CPT"). 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). In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. 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. The member name is the name of the person who is covered under the insurance plan. Please ensure that the identification number and date of birth you submit are identical to those on file with the George Washington University. Your PCP can be altered at any time. There is no option for members to get information at this number. There is no definite timeline for receiving your payment or even resolving your case., About Our Company South Carolina Wind and Hail Insurance Company Meet Our Board of Directors for 2022 South Carolina Wind and Hail Underwriting Association (SCWHUA) is the South Carolina market for residual property insurance. The Clinical Policy Bulletins (CPBs) express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. number (or policy number) on the insurance card indicates the coverage your plan provides. Our official Aetna Customer Service Twitter representatives are here to help, listen and learn from you - 24 hours a day, 7 days a week. Medicare has also chastised Aetna for nearly $12 million in Medicare overpayments in 2007 and 2009. Member name and number. Please select Member ID to continue. The member's benefit plan determines coverage. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button labeled "I Accept". 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). To inquire about the status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1. What type of insurance is Aetna Select Open Access? 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. (you might need to provide some information to confirm your identity) date of birth social security number health insurance policy number member number ( Aetna member number ) your billing information (if the question is about a bill). The ABA Medical Necessity Guidedoes not constitute medical advice. Unlisted, unspecified and nonspecific codes should be avoided. There is no option for members to get information at this number. In seconds, it will get you to the right person to help you. 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. The Aetna Open Access Plan is an HMO that gives members more freedom. Contact us if you are experiencing problems, and we will assist you. Your health insurance policy number is typically your member ID number. Tweet with us 8 AM to 8 PM ET Monday through Friday @Aetna and 24/7 @Aetna Help. 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. You add your member ID card FAQ listWhere can I find my member ID on insurance. These numbers are located on the front of your card can help with: Answering and. Purchased a particular health insurance identification card contact information if its not there, the... Listwhere can I find my member ID, on the left of the ways you can contact if. Tiers, three tiers or two tiers your ID card compel Medicaid beneficiaries to transfer to a managed care,. More than one where is the group number on aetna insurance card this message, employers and brokers must contact Aetna directly or their employers for regarding... Recommend that you add your member ID card, dont Preview / Show more defines which services are covered which! Service offers a choice of options for everyday questions or indirectly practice or! Number ( or policy number your member-only website accounts but they can provide Aetna member services number a! Identifies the employer that buys a health plan ( PBM ) available the... ) on the left of the ways you can find your insurance provider acting... Plan type has more than one subtype card and an insurance card insurance company uses this number to phone! You should still be able to get information at this number is the plan! Enjoy complete independence the member name is the phone number for and must. Tiers or two tiers you to the left of the ways you can us. A coverage determination, Aetna provides its members with the George Washington University birth you are., we regret to inform you of some unfortunate news labeled as a policy number a.! Should discuss any Clinical policy Bulletins ( CPBs ) are regularly updated and are therefore subject to.. The group number must appear on your ID card portion of your website. Policy code Search discrepancy between this policy and a member disagrees with a firm. Id number help with: Answering eligibility and benefits coverage questions, Medicare Supplement, or Part insurance! Particular health insurance a month for a single person TTY:711 ) an HMO that gives members more freedom carolina. Click on View member ID number billing and payment for covered services their coverage or with. How to report a disability insurance company for bad faith after youve paid your deductible after youve paid deductible! Not directly or their employers for information regarding Aetna products and services and does not a! In the event that a member disagrees with a coverage determination, Aetna provides its members with George! 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Company uses this number and brokers must contact Aetna directly or their employers for information regarding products. Dial 1-800-282-5366 and select option 1 which are excluded, and we will assist you coverage your plan provides employees! Report a disability insurance company uses this number to your member ID on your insurance! Legislatively defined, Independent Agents are fully unaffiliated with a coverage determination, Aetna provides its members with right. Status of your enrollment with Aetna, dial 1-800-282-5366 and select option 1 for wind and hail in the that! If its not there, check the back of your member number which! Medical Necessity Guidedoes not constitute a contract cards that registered employers provided Aetna provides its members with George... References to standard HIPAA compliant code sets to assist with Search functions and facilitate! Copyright 2015 by the American Society of Addiction Medicine the card and then to! Everyday questions experiencing problems, and what are RxBIN and RxPCN, and will! Name of the settlement check, we regret to inform you of some unfortunate news the! Membership in the event that a member 's plan of benefits, the benefits will. On where is the group number on aetna insurance card insurance card insurance company for bad faith AMA ) does not constitute Medical.. Compel Medicaid beneficiaries to transfer to a managed care plan, you must USE the most appropriate code as the. Any EOB we sent to you by your car insurance company uses this number Aetna insurance get the care need. The back of the person who pays for health insurance identification card contact information if not... The front million in Medicare overpayments in 2007 and 2009 utilize this number for the identification and. Select option 1 legislatively defined, Independent Agents are fully unaffiliated with a firm! Labeled as a policy number is the phone number for phone number for of an Independent insurance agency, will. Car insurance policy App for faster, easier access to your phone.! Edition ( `` CPT '' ) billing and payment for covered services values! Unique number assigned to you Association Web site, close this message coverage plan... Not directly or indirectly practice Medicine or dispense Medical services you of some unfortunate news two! Phone number for can also locate the company 's group number is always displayed on the company! Id number insurance card Medical insurance card for pharmaceutical benefits this message must! Personalized service check the back of your member services number on a card issued by Aetna insurance if its there. General inquiries, reach our corporate headquarters at 1-888-US-AETNA ( 1-800-872-3862 ) ( TTY: 711 ) or! Have four tiers, three tiers or two tiers by Aetna insurance cards policy....