1. Medical Clinical Policy Bulletins - Aetna
Medical Clinical Policy Bulletins (CPBs) detail the services and procedures we consider medically necessary, cosmetic, or experimental and unproven.
Explore the medical clinical policy bulletins that Aetna uses to decide which services and procedures we will cover.
2. Clinical Policy Bulletins - Aetna
Medical · Formularies & Pharmacy... · Provider manuals
By clicking on “I accept”, I acknowledge and accept that:
3. Clinical Policy Bulletins Alphabetical List - Aetna
Safety Items- CPB-0623 · Salivary Hormone Tests- CPB-0608 · Scalp Cooling (Hypothermia) to Prevent Hair Loss During Chemotherapy- CPB-0290 · Screening for Lipid ...
4. Clinical Policy Bulletins Numerical List - Aetna
0251-Dermabrasion, Chemical Peels, and Acne Surgery · 0253-Injections for Vocal Cord Paralysis · 0255-Inpatient Admission Prior to Surgery (Preop Days) · 0256- ...
5. Clinical Guidelines & Policy Bulletins | Aetna Medicaid [STATE NAME]
Clinical practice guidelines summarize evidence-based management and treatment options for specific diseases or conditions.
6. [PDF] Provider manual - Aetna
*FOR ENTRY REQUIREMENTS: This is assessed for Medical Record Keeping Practices based on guidelines from the ... Criteria — Clinical Policy Bulletins (based on ...
7. Clinical guidelines and policy bulletins - Aetna Better Health
We've chosen certain clinical guidelines to help our providers get members high-quality, consistent care that uses services and resources effectively.
Clinical Policy Bulletins help us decide what health care services and procedures we will and will not cover. Clinical guidelines help our providers get members high-quality, consistent care.
8. [PDF] Provider manual - Aetna
guidelines of medical associations and government agencies, including the ... Criteria — Clinical Policy Bulletins (based on medical and pharmacy Clinical ...
9. Cosmetic Surgery and Procedures - Medical Clinical Policy Bulletins
Abdominoplasty, Suction... · Breast Reduction Surgery · Gender Affirming Surgery
Number: 0031
10. Resources & Support for Health Care Providers - Aetna
Clinical Policy Bulletins · Join the Aetna Network · Request to join Aetna network
Discover all of our resources for health care professionals and join the Aetna providers network. Build relationships while helping patients with Aetna.
11. [PDF] Behavioral Health Provider Manual - Aetna
Treatment approach is expected to be evidence based, goal directed, and consistent with accepted standards of care, Aetna Clinical Policy Bulletins and Aetna ...
12. Injectable Medications - Clinical Policy Bulletins - Aetna
Aetna covers injectable medications when an appropriate oral alternative drug does not exist. This coverage includes those medications intended to be self- ...
Number: 0020
13. Physical Therapy - Medical Clinical Policy Bulletins - Aetna
Physical therapy is generally covered for members with eligible conditions that require improvement in the activities of daily living (ADLs). These include, but ...
Number: 0325
14. Genetic Testing - Medical Clinical Policy Bulletins - Aetna
Aetna considers genetic testing of PTPN11, SOS1, or KRAS genes medically necessary for the diagnosis of Noonan syndrome in persons with characteristic features ...
Number: 0140
15. Aetna Resources | EviCore by Evernorth
Effective December 1, 2021, Aetna® will add a Site of Care medical necessity requirement to the Enhanced Clinical Review program for fully insured commercial ...
eviCore healthcare is pleased to announce its continued partnership with Aetna to provide authorization services for Managed Medicare Advantage and Commercial members.
16. Outpatient Medical Self-Care Programs - Aetna
Clinical Practice Guideline No. 14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research (AHCPR); December 1994. Brady TJ ...
Number: 0169
17. Botulinum Toxin - Medical Clinical Policy Bulletins - Aetna
Aetna considers continuation of onabotulinumtoxinA (Botox) therapy medically necessary for treatment of chronic migraine prophylaxis when the member has ...
Number: 0113
18. Infertility - Medical Clinical Policy Bulletins - Aetna
For women who are less than 40 years of age, the day 3 FSH must be less than 19 mIU/mL in their most recent laboratory test to use their own eggs. For women 40 ...
Number: 0327
19. Viscosupplementation - Medical Clinical Policy Bulletins - Aetna
Aetna considers viscosupplementation (hyaluronates) medically necessary for the treatment of osteoarthritis (OA) in the knee when all of the following criteria ...
Number: 0179
20. View coverage & benefits - Aetna Medicare
Mar 1, 2024 · You can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) ...
You can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) benefit catalog, and more.
21. Aetna international | International Medical Insurance
Aetna International is a worldwide international medical insurance carrier. We work with small and large companies, and producer and broker partners to ...
Aetna International is a worldwide international medical insurance carrier. We work with small and large companies, and producer and broker partners to provide our inpats, expats and local nationals with unmatched global benefits no matter where they are.
22. Meritain Health Follows Aetna Clinical Bulletins
Related Articles ; HIPAA Reminder. December 18, 2015 ; Medicare Part D Notification Requirements. August 21, 2015 ; Section 111 Reporting and the Data Match ...
Meritain Health follows all Aetna Clinical Bulletins. These may be found here.
23. Weight Reduction Programs and Devices - Aetna
For weight reduction medications and associated criteria, see Aetna Pharmacy CPB on Antiobesity Agents: Antiobesity Agents PA Policy. For Aetna's clinical ...
Number: 0039
24. Aetna | Health & Life Insurance Section - the United Nations
Domestic: Call +1 800 784 3991 for support with any questions, concerns or issues. International: Email aiservice@aetna.com for support with ...
This page will provide you with information related to the medical plan offered by Aetna.
25. [PDF] Open Access Aetna Select medical plan Booklet - Howard County
See the How your plan works – Medical necessity and precertification requirements section and the Glossary for more information. This plan provides coverage for ...
26. The Aetna & Memorial Hermann Accountable Care Network
And doctors using technology combined with the latest medical guidelines, helps ensure the most effective, most up-to-date medical care. Aetna Power of ...
Aetna and Memorial Hermann Accountable Care Network are teaming up to redefine health care with Aetna Whole HealthSM. Our new coordinated approach delivers a better patient experience at a much lower cost.
27. Aetna clarifies updated telehealth policy does not apply to fully ...
Dec 11, 2023 · Aetna recently announced it was excluding fully insured commercial plans in all 50 states from its new telehealth policy that took effect ...
Aetna recently announced it was excluding fully insured commercial plans in all 50 states from its new telehealth polic...
28. Medicare Coverage Determinations
One face-to-face visit every other week for months 2-6; One face-to-face visit every month for months 7-12, if you meet the specified weight loss requirements ...
A National Coverage Determination is issued by CMS when a service or drug’s coverage rules change.
29. [PDF] ASTRO Update on Aetna Image Guidance Decision
Aetna stated that per CPT, it is more appropriate to bill 77387-26 instead of 77014. However, when 77387 (Guidance for localization of target volume for ...
30. Obesity Surgery - Medical Clinical Policy Bulletins - Aetna
Surgery is indicated for persons with severe obesity (BMI of 40 kg/m2 or more) or for persons with a BMI of 35 kg/m2 or more and serious co-morbidities such as ...
Number: 0157
31. ACA plan FAQs for providers - Aetna CVS Health
... requirements under the Patient Protection and Affordable Care Act (ACA). ... *FOR DURABLE MEDICAL EQUIPMENT, HOSPITAL ... Aetna Health of California Inc., Aetna ...
Providers, we’ve answered the top questions about Aetna CVS Health Affordable Care Act (ACA) plans. Get answers and information about member eligibility, payment and billing, plan benefits and more for you and your office staff.
32. Aetna provider resources - Carelon Post Acute Solutions
Carelon Medical Benefits Management is proud to announce its partnership with Aetna to provide utilization management for home health services in ...
Carelon Medical Benefits Management is proud to announce its partnership with Aetna to provide utilization management for home health services in Connecticut, Florida, Georgia, Kentucky, Missouri, Ohio, Oklahoma, Pennsylvania, Texas, Virginia, and West Virginia. Please find important announcements, documents, and forms listed below.
