metlife dental fee schedule 2020 for providers

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. 4792 0 obj <> endobj There are several types of coordination of benefits provisions. endstream endobj 4806 0 obj <>stream %PDF-1.4 % hbba`b``30 Ga They will be able to verify your coverage. Some problems may need more than one service to fix. L0621014064[exp0622][All States]. endstream endobj 4801 0 obj <>stream 0000086757 00000 n In Illinois, DMO plans provide limited out-of-network benefits. Sign up at BeneFeds.com or call 1-877-888-3337. 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). Any use of CPT outside of Aetna Clinical Policy Bulletins (CPBs) should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Your and Your You can get a Summary of Benefits from your employer that provides your insurance. Find your dentist now in Aetnas large nationwide network. MetLife Dental 0000035971 00000 n 0000017092 00000 n hbbd```b``v> >d(XM|&c0L*e$li6"A@Lg` hT CPT is a registered trademark of the American Medical Association. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. 0000032811 00000 n QyJh6,j9nsm WL Ogf8jN%7}0Q_%uSiz7XtyLs^14(.x To find out, just call Member Services. *v:G)JeU%IcRr)\%Ts6q^HpCw-yAuYxU'`ho(7;v};}%-`Fuak`Htf,i1+S|@n-2yC%\rk&(NV;*_(bH *-y;tKMJE-V4"%!GUTEj)/3R$F`}C f0]o~lb>9=Grn5+;X@:D?CwX}/fb'e[=A3[ ~m;j\ZOE%H8RsZg ~mH.l%:~EYwO-$Hcm6dqaW[dc( z Hn@})R$R(8I1$o0Z?IT @m$,RRW$_yV? The DMO plan doesnt have any deductibles or annual maximums. These rules determine Metropolitan Life Insurance Company, New York, NY 10166 HTn0?N$vt.taQ"]QI~}kGvc:PXJ ,DDIuEE}%uDp'QMXzm:h?cZH;%*E[*& See Physician-related/professional services for information regarding vision exams and related services. endstream endobj 4802 0 obj <>stream WebJuly 1, 2022 to present Mobile anesthesia for dental services billing guide; Fee schedules. 0000113149 00000 n This search will use the five-tier subtype. 0000036485 00000 n In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. 0000050787 00000 n If so, the primary care doctor will arrange it. Your plan may have a coordination of benefits provision. endstream endobj 4803 0 obj <>stream See Physician-related/professional services.). Some subtypes have five tiers of coverage. Aetna Dental The AMA is a third party beneficiary to this Agreement. Altamonte Springs dentists Boca Raton dentists Clearwater dentists Coral Gables dentists Coral Springs dentists Daytona Beach dentists Delray Beach dentists Englewood dentists Fort Lauderdale dentists Gainesville dentists Grove City dentists 0000038186 00000 n We need to authorize the use of a different provider before treatment. Florida G b-4) \0)0=6AywC(>rdN61a0X5AxwYdF70Lgc;e9f ``x@ W6 endstream endobj 780 0 obj <>/Metadata 30 0 R/Pages 777 0 R/StructTreeRoot 55 0 R/Type/Catalog/ViewerPreferences 798 0 R>> endobj 781 0 obj <>/MediaBox[0 0 612 792]/Parent 777 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 782 0 obj <>stream As a MetLife Vision customer you can access language When your st dentisuggests treatment, have him or her send a claim form, along with the proposed mtreneatt plans and supporting documentation to MetLife. Questions? Dental 0000043626 00000 n 4+t?1zxn nmZn5&xUAX5N(;a,r}=YUUA?z r[ $ If you had coverage under a previous insurance carrier, youll have coverage for certain services by that plan even after your Aetna coverage begins. Periodontal maintenance is for patients whove previously had periodontal treatment. 0000038958 00000 n It describes the services you have coverage for under your plan. For other specialists, a referral may be necessary. Others have four tiers, three tiers or two tiers. Dental Insurance Center - MetLife The Apple Health PDL can be found on the agency's Apple Health PDL page. Check your Aetna Summary of Benefits. Each main plan type has more than one subtype. WebThe sequestration reduction amount for each affected claim will be identified on the explanation of remittance healthcare providers receive from Humana. hb``d``c``e`kgg@ ~'a >/*g3,>Ib1h(ettt4@ ceY Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. MetLife $10 to $50 to extract a tooth. Visit our Forms and publications page to download authorization forms. Log in to find a dentist who accepts your coverage. G!Qj)hLN';;i2Gt#&'' 0 They may differ by plan. Depending on your plan, you may pay for dental care in one of two ways: There are no deductibles or annual dollar maximums. Links to various non-Aetna sites are provided for your convenience only. Each DMO member must select a PCD. Dental FAQ | MetLife Choose a primary care dentist who participates in our network. WebAmount of every $100 in premiums used to pay for claims and administration for the year ending Dec. 31, 2017 You can still visit any licensed dentist, but your out-of-pocket costs may be higher if you choose a non-PPO dentist. Search our network GEHA's 2023 Dental Benefits Need help choosing a plan? To receive maximum benefits, members must choose a participating primary care dentist to coordinate their care with in-network providers. WebProvider Agreement Fee Schedules (Please reference the fee schedule noted in your provider agreement, and if appropriate, check the CMS website to review the fee schedule for Medicaid and Medicare Advantage health plans.) 0000036990 00000 n 163 0 obj <> endobj %%EOF If you are a participating provider with one or more dental benefit plans, you may want to negotiate with those 0000016734 00000 n Aetna has reached these conclusions based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). Some plans exclude coverage for services or supplies that Aetna considers medically necessary. WebWorldwide dental coverage and plans with no deductible New Hires have 60 days to choose benefits. 1s a5S q b6L4 . Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Each covered family member can select their own. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Mk6 }gm QxXs|'5jjr8`deWkh2-a!-q$uz`z78KPM^}BH*Ifv%\P$^E |:.ucN;%|_6:na~D2B z\|C1bm{1W6LkgiE'{yGz:{A'rK4'0msqe#W3X 9ET You may still elect to receive services from a non "lkBJbQkQ~A~>VKmdCD"*>YF.%Vv]-w0 Search for a dentist by name, specialty, ZIP code or the number of miles you are willing to travel. You are now being directed to CVS Caremark site. WebCritical access information for providers MHCP Fee Schedule (MHCP Fee Schedule (dental codes begin on page 55 of the PDF) Fraud, Waste, and Abuse: Combating Medicare Parts C and D Fraud, Waste and Abuse Training Web Based Training Course 2022 Fraud, Waste and Abuse Attestation Fraud, Waste and Abuse Training Log Additional Resources 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.e., will be paid for by Aetna). BG[uA;{JFj_.zjqu)Q startxref Notice: Past billing guides may have broken links. Federal Dental Insurance | MetLife FEDVIP 2023 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. How do providers identify the correct payer? Do you need a barcode cover sheet? Please see your plan documents. Orthodontia (adults and children) You pay 50% of covered services. This applies to services for: For more details, review your plan documents. hb```, cb.0800(_^Xf5VtUm]81JRtsFGIGcSPaf@Z F y'f??XtO?T)c10 i pg*00Ok D & 2023 to February 25, 2023 Telemedicine billing guide, November 2, 2022 to December 31, 2022 Telemedicine billing guide, August 1, 2022 to present Apple Health (Medicaid) physical health audio-only procedure codes, January 1, 2023 to present - Apple Health (Medicaid) audio-only behavioral health codes, August 1, 2022 to December 31, 2022 Apple Health (Medicaid) audio-only behavioral health codes, June 28, 2022 to July 31, 2022 Telehealth services billing guide audio only supplement, May 12, 2023 to present - Clinical policyfor COVID-19, August 1, 2022 to May 11, 2023 Apple Health (Medicaid) clinical policy and billing for COVID-19, July 22, 2022 to July 31, 2022 Apple Health (Medicaid) clinical policy and billing, February 1, 2022 to July 21, 2022 Apple Health (Medicaid) clinical policy and billing, January 1, 2022 to January 31, 2022 Apple Health (Medicaid) clinical policy and billing, View all clinical policy and billing FAQs, June 6, 2020 to December 31, 2021 Apple Health (Medicaid) telemedicine/telehealth brief, May 10, 2020 to June 6, 2020 Apple Health (Medicaid) telemedicine/telehealth brief, April 29, 2020 to May 9, 2020 Apple Health (Medicaid) telemedicine/telehealth brief, May 12, 2023 to present - Apple Health (Medicaid) behavioral health policy and billing, August 1, 2022 to May 11, 2023 Apple Health (Medicaid) behavioral health policy and billing, February 1, 2022 to July 31, 2022 Apple Health (Medicaid) behavioral health policy and billing, April 29, 2021 to January 31, 2022 Apple Health (Medicaid) behavioral health policy and billing, View all behavioral health policy and billing FAQs, July 22, 2022 to present Apple Health (Medicaid) ABA policy and billing, February 1, 2022 to July 21, 2022 Apple Health (Medicaid) ABA policy and billing, January 1, 2022 to January 31, 2022 Apple Health (Medicaid) ABA policy and billing, July 22, 2022 to present Apple Health (Medicaid) FAQ for diabetes education providers, February 1, 2022 to July 21, 2022 Apple Health (Medicaid) FAQ for diabetes education providers, January 1, 2022 to January 31, 2022 Apple Health (Medicaid) FAQ for diabetes education providers, View all FAQs for diabetes education providers, May 3, 2020 to present Apple Health (Medicaid) home health services billing and policy during COVID-19 pandemic, November 20, 2020 to May 2, 2021 Apple Health (Medicaid) home health services billing and policy during COVID-19 pandemic, October 1, 2020 to November 19, 2020 Apple Health (Medicaid) home health services billing and policy during COVID-19 pandemic, View all home health services billing and policy FAQs, July 22, 2022 to present Telehealth requirements for physical, occupational and speech therapy, February 1, 2022 to July 21, 2022 Telehealth requirements for physical, occupational and speech therapy, January 1, 2022 to January 31, 2022 Telehealth requirements for physical, occupational and speech therapy, View all telehealth requirements for physical, occupational, and speech therapy, January 1, 2022 to present Telehealth services in long term care facilities and skilled nursing facilities, May 3, 2021 to December 31, 2021 Telehealth services in long term care facilities and skilled nursing facilities, October 1, 2020 to May 2, 2021 Telehealth services in long term care facilities and skilled nursing facilities, View all Telehealth requirements for LTC and SNF, February 1, 2022 to present Family planning only billing guide telemedicine/telehealth, January 1, 2022 to January 31, 2022 Family planning only billing guide telemedicine/telehealth, May 3, 2021 to December 31, 2021 Family planning only billing guide telemedicine/telehealth, April 1, 2023 to present TransHealth program billing guide, January 1, 2023 to March 31, 2023 TransHealth program billing guide, January 1, 2023 to present TransHealth fee schedule, April 1, 2023 to present Tribal health billing guide, January 1, 2023 to March 31, 2023 Tribal health billing guide, October 1, 2022 to December 31, 2022 Tribal health billing guide, View all Tribal Health Program billing guides, January 1, 2023 to present Tribal health program fee schedule, January 1, 2022 to December 31, 2022 Tribal health program fee schedule, October 1, 2021 to December 31, 2021 Tribal health program fee schedule, July 1, 2022 to present Vision hardware billing guide, January 21, 2022 to June 30, 2022 Vision hardware billing guide, January 1, 2022 to January 20, 2022 Vision hardware billing guide, Guidance for hospitals in billing MCOs for services provided to newborns, January 1, 2023 to present Refer to the.

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