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Availity dental the conduent

Availity dental

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Claims payments can be made to all providers using Electronic Funds Transfer EFT , except providers outside our service area. Providers At LifeMap we're here to support you, in every way we can. How to join the network Medical Providers LifeMap offers a short term medical product that provides temporary health coverage for members who are typically between jobs or waiting for new coverage to kick in.

Dental Providers As a LifeMap contracted dental provider, we can provide you with a pool of potential patients, predictable reimbursement amounts and direct payment.

Provider Admin. Submit a Claim We accept both paper and electronic claims. Find out how to submit a claim to LifeMap. Learn more. Register for eClaims Receiving claims electronically is our preferred method to ensure ease of doing business with us. Make sure you are registered with Availity or the Dental Center to submit eClaims.

Enroll in EFT. State regulations Federal regulations. News and Insights. OfficeLink updates newsletter. Company news. Existing health care professionals Availity provider portal Update your data Utilization management Provider referral directory. Pharmacy Pharmacy services Update pharmacy data Find prescription drug coverage.

Resources Clinical policy bulletins Clinical policy bulletins Clinical policy bulletin overview Medical clinical policy bulletins Dental clinical policy bulletins Pharmacy clinical policy bulletins. Education, trainings and manuals Overview Educational webinars Provider manuals Behavioral health trainings.

Regulations State regulations Federal regulations. Digital authorization status letters PDF Clinical questionnaire When you submit a prior authorization request for certain services, we may pend your request for additional clinical information. All the tools you need, all in one place. All the tools you need, all in one place The Aetna provider portal on Availity helps you spend less time on administration so you can focus more on patient care.

You get a one-stop portal to quickly perform key functions you do every day You can: Submit claims Get authorizations and referrals Check patient benefits and eligibility Upload medical records and supporting documentation File disputes and appeals Update your information You can also stay up to date with the latest applications, resources and news from us.

How to get started. How to get started If your practice already uses Availity, simply contact your Availity administrator to request a username. Set up Availity account Need help registering for Availity? Browse tips, webinars and training to get on board.

Availity registration resources. Working with Aetna educational webinars. Register for a live webinar. Availity portal resources and educational materials. Refer to these helpful resources to better navigate Aetna functionality on Availity. Need help? Legal notices 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.

Health benefits and health insurance plans contain exclusions and limitations. See all legal notices. You are now being directed to the AMA site Links to various non-Aetna sites are provided for your convenience only.

You are now being directed to the Give an Hour site Links to various non-Aetna sites are provided for your convenience only. You are now being directed to the CDC site Links to various non-Aetna sites are provided for your convenience only. You are now being directed to the CVS Health site. You are now being directed to the Apple. You are now being directed to the US Department of Health and Human Services site Links to various non-Aetna sites are provided for your convenience only.

Login Please log in to your secure account to get what you need. You are now leaving the Aetna Medicare website. Error or missing data. Please check your entries for an error message.

This search uses the five-tier version of this plan Each main plan type has more than one subtype. I Accept. I accept. 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.

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. Not all plans are offered in all service areas. All services deemed "never effective" are excluded from coverage. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment.

Visit the secure website, available through www. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool.

No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc.

Disclaimer of Warranties and Liabilities. Treating providers are solely responsible for dental advice and treatment of members. While the Dental Clinical Policy Bulletins DCPBs are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Dental Clinical Policy Bulletins DCPBs describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information.

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.

Your benefits plan determines coverage. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government.

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.

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.

Aetna Clinical Policy Bulletins CPBs are developed to assist in administering plan benefits and do not constitute medical advice. Members should discuss any Clinical Policy Bulletin CPB related to their coverage or condition with their treating provider.

While the Clinical Policy Bulletins CPBs are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Clinical Policy Bulletins CPBs express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. 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.

Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins CPBs. 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.

Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error.

CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. New and revised codes are added to the CPBs as they are updated. When billing, you must use the most appropriate code as of the effective date of the submission.

Unlisted, unspecified and nonspecific codes should be avoided. If there is a discrepancy between a Clinical Policy Bulletin CPB and a member's plan of benefits, the benefits plan will govern.

In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 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. While Clinical Policy Bulletins CPBs define Aetna's clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis.

In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA e. 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.

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Visit UHCdentalproviders. Find the latest announcements, updates and reminders, policy and protocol changes and other important information to guide how your practice works with UnitedHealthcare Dental and our members. Obtain pre-treatment estimates, submit online claims and learn about our claim process.

Review information and trainings designed to help you and your practice. Learn about Medicare Advantage Plans, how they benefit you, and review the quick reference guide to determine what portal to use to check eligibility and submit claims for each plan. Explore the self-paced training module to learn more about using this important resource to support your patients and practice. Get access to more patients, competitive reimbursement rates and dedicated support to help grow your practice.

Search close. Provider Portal. Register Access digital tools to support your practice. Sign in. How to use our portal. Explore the user guide. Start course.

Medicaid Visit UHCdentalproviders. Go to portal. Dental news Find the latest announcements, updates and reminders, policy and protocol changes and other important information to guide how your practice works with UnitedHealthcare Dental and our members. We expect to retire the existing portals in the second quarter of , at which point Humana. Until they are retired, these portals will continue to work normally and offer information to dental providers as they do now. Eastern time. Learn more about how to register and get started with Availity.

Humana and Florida Blue formerly Blue Cross and Blue Shield of Florida jointly formed Availity in , with the goals of improving efficiency, reducing administrative complexity in the healthcare industry and, ultimately, improving healthcare outcomes. Refer a dentist to be part of the Humana network. Assistance is available Monday Friday, 8 a. Eastern time excluding holidays.

For more information on Availity, visit the Availity website. Availity Portal for Humana dental providers.