May/June 2005 - Center Care Health Benefits Programs

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Aetna Offers a Solution to Uninsured Part-Time and Hourly Workers (continued from page 13) There Will be Administrative Differences With These Benefits Plans ■ All Aetna Affordable Health Choices related calls from providers and members will be handled by the SRC customer service staff via a toll-free customer service number (1-888-772-9682) listed on the ID card. ■ We strongly encourage that you call every time to verify eligibility for Aetna Affordable Health Choices patients. At that time please provide the member reference number “SRC5555” to assist in addressing your call promptly. After you call, customer service will send you a benefits and eligibility information fax. The fax is not a guarantee of payment. ■ When submitting claims electronically please use: —Payer ID 57604 —Patient’s Social Security number for the member ID ■ All claims not submitted electronically should include: —Payer ID 57604 —Patient’s Social Security number for the member ID Submit paper claims to: SRC, an Aetna Company P.O. Box 23759 Columbia, SC 29224-3759 For More Information on Aetna Affordable Health Choices If you have questions regarding these new benefits plans, please contact SRC customer services at the number listed above or go to the link on our secure website under Doing Business With Aetna. 14 Aetna OfficeLink Updates
In Your Area ILLINOIS, COLORADO, OHIO, INDIANA, MISSOURI, KENTUCKY AND KANSAS Phone, Fax and Web Contacts for Radiology Precertification National Imaging Associates (NIA) administers Aetna’s radiology utilization management program in your area. NIA has a dedicated toll-free number for Aetna members requiring high-tech radiology precertification. This program affects most Aetna HMO, QPOS ® , Aetna Open Access HMO, Aetna Choice POS and USAccess ® members in your market. Precertification is Required for Certain Procedures The program includes a precertification requirement for certain outpatient, elective, high-technological imaging procedures including: ■ CTs ■ MRI/MRAs ■ PET scans ■ Nuclear Cardiac Imaging Studies Radiology procedures performed during an inpatient stay or in an emergency room do not require precertification. Precertification List Now on the Website A complete list of the outpatient nonemergency, high-tech radiology procedures that require precertification is available on the secure website: 1. Go to the Aetna Communications section under “Doing Business with Aetna.” 2. Select “Mailings,” “2005” and your state. 3. Find “High-Tech Radiology Precertification List.” As a reminder, when calling NIA for precertification, please have the following information available: ■ Aetna member ID number ■ Patient date of birth ■ Current diagnosis, treatment history and plan ■ Patient chart ■ Medications ■ Previous imaging study results For additional information, please contact your Aetna provider relations representative. Pri-Med Updates Milwaukee June 3-4, 2005 Hyatt Regency Milwaukee For more information, visit www.pri-med.com Columbus June 8-9, 2005 Renaissance Columbus For more information, visit www.pri-med.com Pri-Med Conference & Exhibition June 16-18, 2005 Donald E. Stephens Convention Center Rosemont, IL For more information, visit www.pri-med.com Toll-Free Numbers for NIA For Aetna members that require precertification CALL 1-866-326-6304 To submit Aetna precertification requests FAX 1-800-784-6864 Aetna OfficeLink Updates 15
Page 1 and 2: NORTH CENTRAL REGION MAY/JUNE 2005
Page 3 and 4: Working Together Aetna Service Opti
Page 5 and 6: OfficeWise Referral Reminder for Sp
Page 7 and 8: Numbers to Know Provider Service Ce
Page 9 and 10: Clinical, Payment and Coding Policy
Page 11 and 12: Specialties in Practice Women’s H
Page 13: Plan Facts & Features Aetna Offers

May/June 2005 - Center Care Health Benefits Programs

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