Abin da 'yan kasuwa na likita suke bukatar sanin game da Aetna

Yadda za a Sanya Shaƙatawa ga wannan Insurer

Aetna yana samar da shirye-shirye na asibiti na kiwon lafiya da dama, ciki har da wadanda ke da mutane da kuma shirye-shiryen tallafin aiki. Kasuwancin likita zasu iya buƙatar bayani game da yadda za a biyan kuɗi da aiwatar da ikirarin zuwa wannan mai insurer. Ga bayanai a kan matakan su.

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Sanarwar Bayani game da Aetna ga 'Yan Ƙwararrun Kulawa

Lambobin Kira

• Medical and Behavioral Health: Domin HMO da kuma Medicare Riba da tsare-tsaren, kira 1-800-624-0756. Don duk sauran shirye-shirye, kira 1-888-MD-Aetna (1-888-632-3862).
• Aetna Pharmacy Management: 1-800-238-6279
• Dental samar da: 1-800-451-7715
• Gudanarwa ko sake yin takaddama: 1-800-353-1232

Bayanin Adireshin
Aetna Inc.
151 Farmington Avenue
Hartford, CT 06156

Adireshin Yanar Gizo
www.aetna.com/healthcare-professionals

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Aikin Eligibility, Amfanin da Yanayi Matsayi

Lokaci na Lantarki na Gidan Lantarki (RTE)

• Akwai 24 hours a rana, 7 kwana a mako
• Akwai damar zama tare da masu ba da hidima marasa lafiya
• Bayar da ku don neman shawarwari masu amfani har zuwa watanni 18 kafin kwanan wata

Za'a iya tabbatar da cancanta, amfani da halin da'awar a hanyoyi biyu:

1. Ta hanyar hanyar yanar gizo ta Aetna mai amfani ta hanyar NaviNet®, samuwa ta hanyar www.aetna.com/healthcare-professionals
2. Ta hanyar mai sayar da lantarki / tsabta

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Yadda za a Bada Aikata Aikata Aika zuwa Aetna

Shigar da buƙatun buƙatar kafin a ba da sabis ta hanyar sadarwa ta hanyar sadarwa ta hanyar sadarwa (EDI), ta hanyar www.aetna.com/healthcare-professionals ko ta waya ta yin amfani da lambar tarho a kan katin shaidar shaidar memba.

Hanyoyi da ayyuka a kan lissafin ƙaddamarwa zasu iya buƙatar sanarwar da / ko ɗaukar hoto.

• Ƙaddamarwa Tool Tool Search

1. Shigar da lambobin CPT don gano idan ana buƙatar precert

• Ƙaddarar Electronic

1. Akwai 24 hours a rana, Litinin zuwa Asabar
2. Sami lambar ID ID
3. Abun da aka ƙi shi ya ba da lambar ƙira ta musamman

Kara

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Bayar da Bayani na Aiki don Aetna

Akwai hanyoyi masu sauƙi guda uku don gabatar da ƙararrakin zuwa Aetna:

1. Ana iya ƙaddamar da ƙirar lantarki ta hanyar shafin yanar gizo ta Aetna ta hanyar NaviNet®, ta samuwa ta hanyar www.aetna.com/healthcare-professionals.
2. Ana iya ƙaddamar da ƙirar lantarki ta hanyar mai sayar da lantarki / mai tsabta.
3. Takarda takarda za a iya shigar da su ga adireshin imel na Aetna da aka jera a katin katin ID na memba.

Magana na biyu:

• Sanya lantarki
• Ƙara yawan daidaituwa - a duk matakin da'awar da matakin layin sabis (idan akwai)
• Ƙari da dalilai na daidaita - haɗin kwangila, deductible, coinsurance, da dai sauransu. Yi amfani da lambobin da aka ba da kuɗin mai biyan bashin.
• Farashin biyan kuɗin farko - a duka matakin da ake kira da kuma matakin layin sabis (idan akwai).

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Samun bukatun lokaci

Sai dai idan doka ta jihar ko kuma wani batu ya shafi:

1. Magunguna suna da kwanaki 90 daga ranar sabis don mika da'awar biyan kuɗi.
2. Asibitoci suna da shekara guda daga ranar sabis don mika da'awar biyan kuɗi.

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Sharuɗɗan Shari'ar

Lokacin yin canje-canje ga biyan kuɗin da aka rigaya, ƙaddamar da ƙwararriyar ƙirar ta hanyar sadarwa. Ƙaddamar da Dokar Sakamakon Bayanai tare da:
7 = Sauyawa na da'awar da aka rigaya
8 = Maɓallin / soke wani da'awar da ta gabata

Lokacin yin canje-canje zuwa baya sun ƙaryata game da iƙirarin, ƙaddamar da ikirarin da'awar akan takarda:

1. Stamp "BABI GIRMA" a saman da'awar
2. Mail to:
   Aetna
   PO Box 14079
   Lexington, KY 40512-4079

Kara

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Refunds

Sanya da'awar da aka gyara kuma Aetna zai sake farfadowa / sake karbar kuɗin da za a ruwaito a kan ERA tare da sake juyayin adjudication da ba daidai ba, sa'annan bin umarnin gyarawa na da'awar.

Kara

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Bayanan da ake kira Aetna Claim Information

Komawa

1. A cikin kwanaki 180 na yanke shawara na farko
2. A cikin kwanakin kwana 3-5 na karɓar buƙatar. A cikin kwanaki 30 na kasuwancin da aka karɓa idan an buƙata ta hanyar ƙwararren ƙwarewa (alal misali, nazari na asibiti
3. Kira 1-800-624-0756 don tsarin tsare-tsaren HMO da keɓaɓɓe na ABY da kuma kira 1-888-632-3862 don samun albashi da PPO masu amfani da tsare-tsare
4. Adireshin aikawa:
   
   Jihohi
   AL, AK, AR, AZ, CA, FL, GA, HI, ID, LA, MS, NC, NM, NV, OR, SC, UT, TN, WA
   Adireshin
   Aetna PO Box 14079 Lexington, KY 40512-4079
   Jihohi
   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
   Adireshin
   Aetna PO Box 981106 El Paso, TX 79998-1106
5. Sanya yanar gizo ta hanyar kayan aikin bincike na EOB. Shiga cikin shafin yanar gizon yanar gizo mai kyau ta hanyar NaviNet® don samun damar wannan kayan aiki.

Ƙaƙasawa na matakin matakin 1

1. A cikin kwanaki 60 na ranar yanke shawara
2. A cikin kwanaki 30 na kasuwanci bayan karɓar buƙatar. Idan ana buƙatar ƙarin bayani, a cikin kwanaki 30 na karɓar karɓar ƙarin bayanin da aka nema
3. Kira 1-800-624-0756 don tsarin tsare-tsaren HMO da keɓaɓɓe na ABY da kuma kira 1-888-632-3862 don samun albashi da PPO masu amfani da tsare-tsare
4. Rubuta Aetna Provider Resolution Team PO Box 14020 Lexington, KY 40512

Level 2 Kira (samuwa kawai ga masu aiki)

1. A cikin kwanaki 60 na ƙaddamar da ƙuri'a na matakin 1
2. A cikin kwanaki 30 na kasuwanci bayan karɓar buƙatar. Idan ana buƙatar ƙarin bayani, a cikin kwanaki 30 na karɓar karɓar ƙarin bayanin da aka nema
3. Kira 1-800-624-0756 don tsarin tsare-tsaren HMO da keɓaɓɓe na ABY da kuma kira 1-888-632-3862 don samun albashi da PPO masu amfani da tsare-tsare
4. Rubuta Aetna Provider Resolution Team PO Box 14020 Lexington, KY 40512

Kara