Tricare Regions Phone number and Claims address - Dental Claims Tricare Phone Number Tricare Address; Tricare Active Duty Dental Program Claims address: 866-984-2337: Dental Claims address: PO Box 69429 Harrisburg, PA 17106 - 9429: Tricare Dental Program Claims address: CONUS: 844-653-4061 OCONUS: 844-653-4060: Dental Claims address: CONUS . P.O. We respond to messages from 8am-6pm EST, Monday-Friday. Contact Aetna Or you can mail hard copy claims or resubmissions to: Aetna Better Health of Ohio (MyCare Ohio Program) PO Box 64205. Important Contact Information. Nippon Life Benefits - Contact Us Aetna Complaints Postal Service employees, annuitants, and their eligible family members, and as of 1/1/2019, TRICARE eligible individuals. Get and Sign Aetna Claim Form 2012-2021 . PDF Dental Benefits - Claim Instructions - Aetna Otherwise, please send an individual W-9. 3. You can also reach us Monday through Friday from 7 a.m. - 7 p.m. Central time. Employee's Address (include ZIP Code) Address is new 8. To contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM—5PM (Monday—Thursday), 9AM—5PM (Friday). Enter your official contact and identification details. Please mail all enrollment forms to above address and indicate the type of plan on the envelope. Patient's Gender 15. We may need to contact the claimant's dental practitioner, for more dental information in order for us to process the claim under the terms and conditions of the policy. If you prefer to contact Member Services with this public form, please complete the information below. Magellan Behavioral Health: Call Collect (314) 387-4700 (Available 24/7) Aetna's 24 Hour Nurse Line: (800) 255-2386. PDF Dental Program (Salaried) Submit a complaint online . A contact list of insurance companies and administrators that DenteMax works with can be found in the Dentist Portal. AARP Dental Insurance Plan AARP1 835 . Contact Us | DenteMax Dental PPO Network Aetna is a member of the Fortune 500. TO THE EMPLOYEE 1. Utilizing The Aetna Dental Access® Network. Contact Aetna.com AetnaMedicare.com Join The Network Working with Claims Electronic Solutions Resources Programs Helpful Links Log Register Log Log Forgot username Forgot password Log help New User Dental Providers Register now for AetnaDental.comMedical. Name and address; If different from billing provider, also send rendering/servicing provider name, address and NPI. Aetna Provider Phone Number for below plans - 800-624-0756. Box 21542 Eagan, MN 55121 GEHA FEHB Dental P.O. Be certain to sign the authorization to release information in block 28. For complete terms and conditions, review the claim form. (8 days ago) Mail this completed form and your original receipts and itemized bills to the medical claims address on your Aetna Medicare member ID card. Send UB04 claims to: PO Box 933, New York, NY 10108-0933. We also have a Dental Discount Implant Program for our existing dental insurance customers. Fax the form to: 1-866-756-5514. Are you a savings plan member? Box . Print a complaint form and fax or mail it to the address shown on the form. Complete blocks 23-27 only if other dental coverage exists. 7400 W. Campus Rd. Plan Sponsor Services Mailing Address. However, when the Covered Family Members in a family have Or you can mail hard copy claims or resubmissions to: Aetna Better Health Premier Plan MMAI. The benefits are clear. 1. Stay in-network and save on your next visit* Choose an in-network provider . Or you can fax this completed form, your original receipts and itemized . Discount Vision through the Outlook Vision Network. Eagan, MN 55121. Payer Claims List Payer ID Payer Name Req. Claims & Correspondence Rural Carrier Benefit Plan P.O. Discount Dental Utilizing The Aetna Dental Access® Network. Get all the information and advice you'll need in order to make a health care claim as an Aetna International member. Complete blocks 1-22 in full. All claims and specialist authorizations Aetna Dental P.O. P.O. Claims submission made easy This form can be used to submit a claim for medical, dental, vision, or pharmaceutical services. n Submit all dental or vision claims, regardless of location, to the Medical Mutual Claims Submission address. Here are our medical, dental and medicare claim forms. If you need the five-digit payer ID number to show the destination of the claim, use 60054 for Aetna claims, and 68246 for Aetna encounters. 800-238-6279. Optumrx.com; Member Services (855) 409-6999; TTY 711; Fax (866) 713-6511; 24 hours a day, 7 days a week, 365 days a year; Mailing Address; Pharmacy Claims Address: OptumRx Claims Department Medical Dental. Call us at the number on your ID card. Enroll. Toll Free: 1-866-316-3784. Once providers are loaded, Aetna will align applicable authorizations for Aetna Better Health members to specific providers to pay claims. Employee's Birthdate (MM/DD/YYYY) 6. Topic* Please select a topic for your inquiry Billing Question Other. London, KY 40702. The address for our administrative office is: Aetna Dental Federal Plans PO Box 550 Blue Bell, PA 19422-0550. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and Electronic Remittance Advice. Aetna Medical and Behavioral health. the Most Secure Digital Platform to Get Legally Binding, Electronically Signed Documents in Just a Few Seconds. and include the provider name and service location information. 151 Farmington Avenue, Hartford, CT 06156. With ID card requests and claim inquiries. Holistic Help. Benefits commence after a Covered Family Member has incurred $50 in Covered Dental Expenses in a calendar year. Southfield, MI 48034. Aetna complaints contacts. If you missed Open Enrollment, please contact your HR representative immediately. Phone: 888-287-4206. or email us at MA SG Plan Sponsor Inquiries. Aetna Dental www.aetnafeds.com 1-800-554-2042 . Contact Aetna.com AetnaMedicare.com Join The Network Working with Claims Electronic Solutions Resources Programs Helpful Links Log Register Log Log Forgot username Forgot password Log help New User Dental Providers Register now for AetnaDental.comMedical. To send a complaint to Medicare, complete the Medicare Electronic Complaint form . Mail this completed form and your original receipts and itemized bills to the medical claims address on your Aetna Medicare member ID card. Please submit this form within 365 days from the date you received the service or . Policy/Group Number 3. Start a Free Trial Now to Save Yourself Time and Money! Box 21542. Get and Sign Aetna Dental Claim Forms Download 2018-2021 . Monday - Thursday 8am - 5:30pm EST Friday 8:30am - 5:30pm EST. Make sure you know what to do before you submit your claim, any referral letters you'll need and how to submit medical claims to Aetna International online or by fax, email and traditional mail. Member Services. Box 981106, El Paso, TX 79998-1106.For information, call 1-888-332-8742.. Those individuals enrolled in Aetna managed medical care program administered by Aetna under the Railroad Employees' National Health . Contact your Provider Services representative for more information on electronic billing. . Claims - if you have questions about claims, contact the Provider Service Center (see list below) Credentialing - 1-800-353-1232 (TTY: 711) Dental providers - 1-800-451-7715 (TTY: 711) All medical claims should be mailed to the addresses listed below for each network. Send Medical and Dental Claims to: Nippon Life Insurance Company of America PO Box 25951 Shawnee Mission, KS 66225-5951 Electronic Claims - Payer #81264. 3. n Submit medical claims to Aetna* if the service rendered was outside Ohio or Boone, Campbell or Kenton counties in Kentucky. For out-of-network providers seeking . To get an interpreter or to ask about written information in your language, first call your plan's phone number at 800-443-2995. Aetna is one of the approved carriers to offer Federal Employees a supplemental dental plan under this program. Aetna, Inc. 1425 Union Meeting Road. TO THE EMPLOYEE - USE BLACK INK ONLY 1. New Albany, OH 43054. Aetna Medicare 9401 Indian Creek Parkway Suite 3100 Overland Park, KS 66210 Attn: Angie England Download the VA permission form 1 If you don't have creditable coverage for 63 days or more, you may have to pay a late enrollment penalty. Aetna (www.aetna.com)Those individuals enrolled in the Aetna managed medical care program administered by Aetna under the NRC/UTU Health and Welfare Plan should send claims to Aetna, P.O. Resubmitted claims should be clearly marked "Resubmission" on the envelope. When you stay in-network, you save more money and get the full value of your vision benefits. AETNA Billing Address . The Aetna PPO network is a national network with over 680,000 healthcare professionals and over 6,000 hospitals participating. Box 21542. The following outlines the timeline of this process: HCBS providers, whether participating or non-participating providers with Aetna Better Health, will be loaded by January 18, 2019. Aetna Dental PPO (In-Network and Out-of-Network) Aetna Dental DMO (In-Network Only) Dental Program Lifetime Maximum Benefit None . #60054 would be the payor id for most of the clearing house however double confirm the same with your clearing house. Available for PC, iOS and Android. Patient's Birthdate (MM/DD/YYYY) 14. Send EyeMed Vision Claims to: FAA / EyeMed Vision Care 4000 Luxottica Place Mason, OH 45040 800-521-3605 Full and returned within 180 days of the treatment date. Mail to the Aetna Active and Early Retiree Medical claim office using the below address: Aetna Medical Claim Form Aetna PO Box 981106 El Paso, TX 79998-1106 Aetna Dental Claim Form Mail to the Aetna Dental claim office using the below address: Aetna PO Box 14094 Lexington, KY 40512-4094 Massachusetts license number: 10041444. 3. Eagan, MN 55121. Or you can fax this completed form, your original receipts and itemized bills to 1-866-474-4040. Box 21542 Eagan, MN 55121 To review Aetna dental plan options for current employees or retirees, select dental in the menu bar, then employee dental plans or retiree dental plans. Phoenix, AZ 85082. Employee's Name 5. 3. California license number: OB84599. Fill Out, Securely Sign, Print or Email Your Print an Aetna Claim Form - Aetna Student Health Instantly with SignNow. The advanced tools of the editor will lead you through the editable PDF template. Phoenix, AZ 85082. Aetna members, you can Log in or Register for the Aetna Navigator secure member website to manage your benefits--view claims, find a doctor, check eligibility information, order ID cards and more--and contact us in a secure environment. Aetna Better Health of Michigan Members. Medicare Medical Claim Reimbursement Instructions. Pharmacy. Resubmitted claims should be clearly marked "Resubmission" on the envelope. You can also send us a secure email by logging in to www.aetnainternational.com and clicking 'Contact us'. Send CMS 1500 claims to: PO Box 1007, New York, NY 10108-1007. NULL No 36575 No 59069 21st Century Health (MedsavUSA)(NJ) No 74237 32 Dental (PO Box 9150, Austin, TX) Yes 20413 3P Administrators (Onalaska, WI) No 20446 6 Degrees Health Inc. (Beaverton, OR) No CX044 A & I Benefit Plan Admin, Portland Oregon No 39640 A&D Charitable Foundations (Eden Prairie . 2. 888-632-3862. Save up to 80% on your brand-name medications through mail-order. For Illinois North and Central members Prescription drug services: Email us or call 1-844-741-8423 (TTY: 711), seven days a week, 24 hours a day. Be sure to identify the related tooth number for all dental procedures and include extraction dates or original placement date and reason for 4. Or you can mail the form to: Allina Health | Aetna Medicare. To speak with a representative, call us at 1-877-459-6604. Employer's Name 2. Fax: 866-847-4039. Mail this completed form and your original rece ipts and itemized bills to the medical claims address on your Aetna member ID card. How to fill out the Aetna provider appeal form on the web: To start the blank, utilize the Fill & Sign Online button or tick the preview image of the form. If you're filing a claim for more than one person, a 3. Aetna was ranked by Fortune magazine as one of the most admired healthcare insurers in the world. If you are already an Aetna Dental Insurance Member and have a question regarding your existing policy or claim, please visit Aetna.com or call 1-800-872-3862. SUBMISSION OF CLAIMS, THE PROVIDER MAY CONTACT THE AETNA CLAIM PROCESSING CENTER FOR INFORMATION REGARDING ELECTRONIC CLAIM SUB MISSIONS. the claim, you may submit a paper Medicare Supplement claim to: Aetna Senior Supplemental Insurance P.O. GEHA Connection Dental Federal (FEDVIP) OptumRx. † For all dental claims (other than preventive services, e.g. Complete blocks 1-22 in full. I have a question about Aetna Dental Insurance. Patient's Aetna ID Number 11. Coventry (Including workers compensation and auto injury) 800-937-6824. No oral statement can modify or otherwise affect the benefits, limitations . Aetna Inc. is an American managed health care company, which sells traditional and consumer directed health care insurance plans and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans. Call 800.821.6136 for help with your medical plan, or call 877.434.2336 for help with your dental plan. Aetna Better Health Premier Plan (Medicare-Medicaid) Mail. For your convenience, we have a single post office box for claims and specialty authorization submissions. Dental. Please review your 1199SEIU patient's dental identification card to identify the carrier and locate associated contact information . Aetna Medicare Reimbursement Form. P.O Box 7405. on the back of your Aetna ID Card. Yes No. If you have questions, suggestions, or even complaints, please contact us by phone or by mail: Customer Service 800-638-8432. You are now leaving the Aetna Dental Web site and linking to ClaimConnect*. your Aetna ® member ID number on each receipt an d bill. Resubmitted claims should be clearly marked "Resubmission" on the envelope. If you missed Open Enrollment, please contact your HR representative immediately. Persons with speech or hearing impairments can contact us at 800.735.2966. Diabetic Supplies. Contact your Provider Services representative for more information on electronic billing. Blue Bell, PA 19422. 2. 28588 Northwestern Hwy, Suite 380B. Walk-In Pharmacy Prescription Savings. Complete blocks 23-27 only if other dental coverage exists. This is a solicitation for insurance and a licensed insurance agent or insurance company may contact you. Aetna. Employee's Aetna ID Number 4. Or you can mail hard copy claims or resubmissions to: Aetna Better Health Premier Plan MMAI. All dental claims should be mailed to GEHA at the appropriate address below: GEHA FEHB Medical. By calling the AVA National Dentist Line at 1-800-451-7715, you can: Check on several patients in a single call to a single number. Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and Electronic Remittance Advice. Section 8 must be completed by the dental practitioner, if required. PO Box 66545. 2021 . The Rural Carrier Benefit Plan and Aetna are here to help you with your health care needs. You must also include a copy of the new W-9, if applicable. For out-of-network providers seeking . Continue You are now being directed to the CVS Health COVID-19 testing site Policyholder (Member) Information - Must be completed. Quality CBD Products. Things to remember 1. Aetna Better Health of Nebraska (for claims with DOS prior to 1/1/17) 42130 837 ERA Payer Code 25133 Aetna Better Health of New Jersey 46320 837 . Or you can mail hard copy claims or resubmissions to: Aetna Better Health of Ohio (MyCare Ohio Program) PO Box 64205. Support. Our representatives can help: Answer questions about benefits coverage. Aetna has more address but usually accept all the claims whatever address you submit from the below list. 1-800-537-9384. www.aetnafeds.com. Find network providers. Please fax a letter to 1-859-455-8650 with details of the TIN change being requested (leaving, joining group, etc.) Mental health & substance abuse care: Email us or call 1-800-423-8070 (TTY: 711), seven days a week, 24 hours a day. Things to remember 1. We'll get back to you within 30 days (24 hours if you request a faster response). They also include a Phoenix, AZ 85082. Visit Contact Member Services It is a program where supplemental dental and vision benefits are available to eligible Federal and U.S. Aetna Voice Advantage ® (AVA) Use our interactive telephone self-service system to check claims and patient eligibility. This brochure is the official statement of benefits. Dental, Vision and Hearing Insurance plans are offered and/or underwritten by Continental Life Insurance Company of Brentwood, Tennessee, an Aetna Company (Aetna). Box 14094 Lexington, KY 40512-4094 All dental Medicare claims Claim Forms. If you do not currently submit claims electronically, contact one of our preferred clearinghouses: Change Healthcare at 1-844-217-1199 (email is dentalsupport@changehealthcare.com) DentalXChange at 800-576-6412 (ext. Medical Claim Form (PDF) Dental Claim Form (PDF) Vision Claim Form (for vision included in medical plans) (PDF) Vision Claim Form (for FEDVIP Aetna Vision℠ Preferred Plan) (PDF) Aetna Direct plan Medicare Part B Premium Reimbursement Request Form (PDF) HealthFund Reimbursement Form (PDF) Deemed Exhaustion and Immediate Claims Appeal. Employee's Daytime Telephone Number ( 10. Please submit this form within 365 days from the date you received the service or . 452 for support; ext. Aetna Student Health Agency Inc. is a duly licensed broker for student accident and health insurance in the Commonwealth of Massachusetts. PO Box 66545. The Aetna state of New Jersey website at AetnaStateNJ.com is the resource for Aetna dental plan options for state of New Jersey employees, their families, and retirees. For HMO plans, you must see a dental care provider within the network of approved providers. Filing Claims and Claim Appeals The Dental PPO and DMO options include rules for filing claims, such as time limits and the information required. I have a question about billing. You are now leaving the Aetna Dental Web site and linking to ClaimConnect*. Contact your Provider Services representative for more information on electronic billing. To contact our local staff, call 671-472-3862 or email GovGuamServices@aetna.com from 8AM—5PM (Monday—Thursday), 9AM—5PM (Friday). 455 for enrollment services) Tesia Clearinghouse, LLC at 800-724-7240. oral exams, x-rays, cleanings, fluoride, etc), complete the Dentist's Statement (GC-14423) and attach to this claim form. 2. Check the status of a claim or claims. All dental claims should be mailed to GEHA at the appropriate address below: GEHA FEHB Medical P.O. Or you can fax this completed form, your original receipts and itemized bills to 1-866-474-4040. Preferred Network providers across the nation, you have access to *If you don't have a creditable prescription drug coverage for 63 days or more, you may have to pay a late enrollment penalty. Resubmitted claims should be clearly marked "Resubmission" on the envelope. For ADA claims: The Benefit Funds do not administer dental benefits for 1199SEIU members. Box 14770 Lexington, KY 40512-4770. Plus, with Aetna Vision. 800-451-7715. Use current CDT codes (five-position codes starting with the letter "D") for each . FASTER, EASIER SUBMISSION OF CLAIMS, THE PROVIDER MAY CONTACT THE AETNA CLAIM PROCESSING CENTER FOR INFORMATION REGARDING ELECTRONIC CLAIM SUBMISSIONS. Policy Name Policy Number Member's Name Member's Date of Birth Member Aetna Identification Number (found on the member ID card) Street Address City State/Province Country Postal/ZIP Code Member's Telephone Number Mobile Number Member's E . It is one of the largest and most respected health benefits companies in the United States, serving over 37 million people. All materials submitted will be retained by us and cannot be returned to you. Address Changes. If you need to make any changes to your mailing address, please contact ExxonMobil Benefit Administration at hr.medical@exxonmobil.com. NCE GapAfford Plus Discount Program | 888-886-1796. For PPO plans and most HMO-POS plans, you have the option to go to any licensed provider, but could save money by using a provider in the network. Contact your Provider Services representative for more information on electronic billing. Apply a check mark to point the choice wherever . Included in some health plans. Preferred Clearinghouses. Together, Banner and Aetna are taking a new approach to the way health care is offered. Healthplex is one of the largest dental insurance providers in the state of NY. 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. Active Retired Date of Retirement 7. Mail to: Aetna Dental PO Box 14094 Lexington, KY 40512-4094 TO BE COMPLETED BY EMPLOYEE - USE BLACK INK ONLY 1. If you need more help, call the HMO Help Center at 888-466-2219 (for prepaid dental), or the CA Dept. 3. Student health insurance plans are underwritten by Aetna Life Insurance Company (Aetna). Get the electronic payor id for Faster process. Assessment of the claim may be delayed if all the necessary sections of this form are not completed. Coventry Health Care of Illinois, Inc. Phoenix, AZ 85082. Some interesting claim submission facts: • On average, Aetna Senior Supplemental Insurance receives 60,000 paper claims each month. Since DenteMax is a dental PPO network which is leased to insurance companies and other organizations, you'll need to first contact the insurance company directly regarding your claim being processed incorrectly. Dental. Aetna MA plans offer three types of dental coverage: Network. If you are contracted as a group, please send a group W-9. All other questions: Email us or call 1-866-784-4916 (TTY: 711), ${hours}. of Insurance at 800-927-4357 (for PPO dental). SM. The Aetna Grievance and Appeals Unit also has one box for all states except California, which has a separate box. As a member of the Dentachoice program, you have access to a national network of over 263,000 available dental practice locations through one of the largest dental discount networks in America, the Aetna Dental Access® Network.Participating dental locations provide savings that range from 15-50%** per visit, on average, on dental services . Healthplex has Dental Insurance and Dental Discount plans for Individuals and Groups of all sizes. Learn more about this innovative partnership, and how these two industry leaders aim to provide more efficient and effective patient care at a more affordable cost. you and your family, please contact Aetna at the number listed on page 5, your labor representative, or your supervisor. 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