Ke Bakoli ba Bongaka ba Hlokang ho Tseba'ng ka Aetna

Tsela ea ho romella litlaleho ho ena ho inshorense

Aetna e fana ka mananeo a sa tšoaneng a inshorense ea bophelo bo botle, ho kenyelletsa le bakeng sa merero ea batho ka bomong le mosebetsing. Barekisi ba tsa bongaka ba ka hloka tlhahisoleseding mabapi le hore na ba ka lefa joang le ho sebetsa litlaleho ho insurer ena. Boitsebiso bo mabapi le mehato ea bona ke ena.

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Tlhahisoleseding e akaretsang ka Aetna bakeng sa Balisisi ba Bongaka

Iteanye le Numere

• Bophelo ba Bongaka le Boitšoaro: Merero ea HMO le Medicare Advantage, re letsetsa 1-800-624-0756. Bakeng sa merero eohle, bitsa 1-888-MD-Aetna (1-888-632-3862).
• Tsamaiso ea Aetna Pharmacy: 1-800-238-6279
• Bafani ba meno: 1-800-451-7715
• Sebaka sa ho tseba ho tseba kapa ho ba le boitsebiso bo bocha hape: 1-800-353-1232

Tsebiso ea Aterese
Aetna Inc.
151 Farmington Avenue
Hartford, CT 06156

Aterese ea Websaete
www.aetna.com/healthcare-professionals

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Aetna Eligibility, Melemo le Boemo ba Boipiletso

Eligibility ea nako ea 'nete ea elektronike (RTE)

• E fumaneha lihora tse 24 ka letsatsi, matsatsi a 7 ka beke
• E fumaneha ho bafani ba tlhokomelo ea bophelo bo botle le ba sa boneng
• E u lumella hore u tlise melemo ea lipotso bakeng sa likhoeli tse 18 pele ho letsatsi la hona joale

Tšoaneleho, melemo le maemo a ho batla li ka netefatsoa ka litsela tse peli:

1. Ka k'homphieutha ea mofani oa Aetna ka NaviNet®, e fumanehang ho www.aetna.com/healthcare-professionals
2. Ka mohoebi oa thepa ea elektronike / ntlo ea ho hloekisa

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Tsela ea ho kenya pelaelo pele ho kopo Kopo ea Aetna

Tlatsa likopo tsa precertification pele u fana ka lits'ebeletso ka ho fapanyetsana ka litaba tsa elektronike (EDI), ho sebelisa www.aetna.com/healthcare-professionals kapa ka thelefono ho sebelisa nomoro ea mohala ka karete ea boitsebiso ba setho.

Mekhoa le litšebeletso tsethathamong tsa li-precertification li ka 'na tsa hloka tsebiso le / kapa boikemisetso ba ho phatlalatsa.

• Selefouno sa Precertification Search Tool

1. Kenya likhoutu tsa CPT ho fumana hore na precert e hlokeha

• Electronic Precertification

1. E fumaneha lihora tse 24 ka letsatsi, Mantaha le Moqebelo
2. Amohela nomoro ea ID ea tiisetso
3. Tlhahiso e hanang e fuoa nomoro e ikhethang ea ho latela

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Boitsebiso ba Lefa bakeng sa Aetna

Ho na le litsela tse tharo tse bonolo tsa ho romella litlaleho ho Aetna:

1. Litlhaloso tsa elektronike li ka fetisoa ka websaeteng ea mofani oa Aetna e bolokehileng ka NaviNet®, e fumanehang ho www.aetna.com/healthcare-professionals.
2. Litlaleho tsa elektronike li ka fetisoa ka mohoebi oa thepa ea elektronike / ntlo ea ho hlakola.
3. Litlaleho tsa pampiri li ka fetisetsoa ho aterese ea Aetna ea poso ea poso e thathamisitsoeng ka karete ea ID ea setho.

Litaba tse ka sehloohong:

• Ngolisa ka elektronike
• Kenyeletsa liphetoho tse ngata-moemong oa bobeli ba boipiletso le boemo ba litekanyetso tsa tšebeletso (haeba e le teng)
• Kenyeletsa mabaka a liphetoho - boikarabello ba konteraka, ho fokotsa chelete, lichelete tsa tšebelisano-'moho, joalo-joalo. Sebelisa lits'ebetso tse fanoeng ke tefo ea moputso oa basebetsi
• Palo e lefshoa ea moputso e lefshoa - boemong ba bobeli ba boipiletso le boemo ba moeli oa tšebeletso (haeba e le teng)

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Litlhoko tsa ho Finyella ka nako e loketseng

Ntle le ha molao oa molao kapa sekhetho se seng se sebetsa:

1. Lingaka li na le matsatsi a 90 ho tloha letsatsing la ts'ebeletso ho fana ka mobu oa tefo.
2. Lipetlele li na le selemo se le seng ho tloha letsatsing la ts'ebeletso ho fana ka mobu oa tefo.

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Litlhaloso tse lokisoang

Ha u etsa liphetoho litabeng tsa pele tse lefuoang, tsamaisa lipolelo tse lokisoang ka elektronike. Hlahisa Frequency Code ea Claim ka:
7 = Ho nkeloa sebaka ha pelaelo ea pele
8 = Tlosa / ho hlakola ea boipelaetso pele ho moo

Ha u etsa liphetoho ho lipolelo tse hanngoeng pele, tsamaisa lipolelo tse nepahetseng pampiring:

1. Setempe "HO BONTŠA HORE HO HLOKETSE" holimo ka holimo
2. E-mail ho:
   Aetna
   PO Box 14079
   Lexington, KY 40512-4079

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Litefello

Fana ka litlamorao tse amohelehang 'me Aetna e tla khutlisa / e tsosolose moputso o lefelloeng o tla tlalehoa ka ERA ka phetoho ea boipelaetso bo fosahetseng, e lateloa ke nyeoe e lokisoang ea boipiletso.

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Boitsebiso ba boipiletso ba Aetna Claim

Ho nahanisisa

1. Matsatsing a 180 a kalendara ea qeto ea pele ea boipiletso
2. Matsatsi a mararo a mararo a mararo ka mor'a ho amohela kopo. Matsatsing a 30 a khoebo ha u fumana kopo haeba ho hlahlojoa sekala se ikhethileng se hlokahalang (mohlala, tlhahlobo ea khokahano ea kliniki
3. Bitsa 1-800-624-0756 bakeng sa merero ea melemo ea HMO le merero ea MA ea Boipheliso e ka sehloohong kapa pitso 1-888-632-3862 bakeng sa merero ea melemo le ea PPO-based benefits
4. Liaterese tsa melaetsa:
   
   States
   AL, AK, AR, AZ, CA, FL, GA, HI, ID, LA, MS, NC, NM, NV, OR, SC, UT, TN, WA
   Aterese
   Aetna PO Box 14079 Lexington, KY 40512-4079
   States
   CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MO, MO, MO, MO, MO, MO, NE, ND, NJ, NY, OH, OK, PA, SD, TX, VA, VT, USA, WV, WY
   Aterese
   Aetna PO Box 981106 El Paso, TX 79998-1106
5. Romella inthaneteng ka sesebelisoa sa ho batla sa EOB. Kena ho websaeteng ea mofani ea sireletsehileng ka NaviNet® ho fumana sesebelisoa sena.

Boipiletso ba Level 1

1. Matsatsing a 60 a almanaka a qeto ea ho nahana hape
2. Matsatsi a mararo a mararo ka mor'a ho amohela kopo. Haeba tlhahisoleseding e eketsehileng e hlokahala, ka hare ho matsatsi a 30 a kgwebo ho amohela tlhahisoleseling e batliloeng e eketsehileng
3. Bitsa 1-800-624-0756 bakeng sa merero ea melemo ea HMO le merero ea MA ea Boipheliso e ka sehloohong kapa pitso 1-888-632-3862 bakeng sa merero ea melemo le ea PPO-based benefits
4. Ngola Aetna Provider Resolution Team PO Box 14020 Lexington, KY 40512

Tlhaloso ea Lekala la 2 (e fumanehang feela ho litsebi)

1. Matsatsing a 60 a almanaka ea qeto ea boipiletso ba Level 1
2. Matsatsi a mararo a mararo ka mor'a ho amohela kopo. Haeba tlhahisoleseding e eketsehileng e hlokahala, ka hare ho matsatsi a 30 a kgwebo ho amohela tlhahisoleseling e batliloeng e eketsehileng
3. Bitsa 1-800-624-0756 bakeng sa merero ea melemo ea HMO le merero ea MA ea Boipheliso e ka sehloohong kapa pitso 1-888-632-3862 bakeng sa merero ea melemo le ea PPO-based benefits
4. Ngola Aetna Provider Resolution Team PO Box 14020 Lexington, KY 40512

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