![]() Health insurance plans contain exclusions and limitations. Provider participation may change without notice. Providers are independent contractors and are not agents of Banner|Aetna. An application must be completed to obtain coverage. 98point6 is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan. Access to 98point6 ® is not included in all plans. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy ® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health ® family of companies.ĩ8point6 ® is a registered trademark of 98point6 Inc. denied as outside the timely filing limit. Each insurer has sole financial responsibility for its own products. AINPEC-0236-22 February 2022 Reimbursement Policy Subject: Corrected Claims Policy Number: G-16001 Policy Section: Administration Last Approval Date: 07/23/21 Effective Date: 07/23/21. Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. Our law department makes the final determination if there is any question regarding the applicability of any particular law. If our policy varies from the applicable laws or regulations of an individual state, the requirements of the state regulation supersede our policy when they apply to the member’s plan. Coordination of Benefits (COB) Employee Assistance Program (EAP) Medicaid disputes and appeals. ![]() ![]() Address, phone number and practice changes. The member appeal process applies to appeals related to pre-service or concurrent medical necessity decisions.Īpplication of state laws and regulations Find forms and applications for health care professionals and patients, all in one place. For these issues, the practitioner and organizational provider appeal process only applies to appeals received subsequent to the services being rendered. These issues relate to decisions made during the precertification, concurrent or retrospective review processes for services that require precertification. For example, issues related to the provider contract, our claims payment policies, or processing errors. These issues relate to all decisions made during the claims adjudication process. Aetna changed the standard nonparticipating-provider timely filing limit from 27 months to 12 months for traditional medical claims. This quick reference guide shows you when and where to submit disputes Issue types ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |