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This page contains articles, resources/links and tips related to Aetna.
Aetna ArticlesClick the article title to view a summary and link to the full article. September 25th, 2015 Coordination of Benefits| Published September 25th, 2015 Coordination of benefits, (COB) is a clause in most group policies, which is in place to minimize the over-payment or duplicate payment of claims. COB applies to patients covered by more than one insurance plan and limits the amount paid by each plan.
With the COB clause the payments made by ... February 25th, 2015 Aetna Policy on Bathroom and Toilet Equipment and Supplies - Coverage| Published February 25th, 2015 - Last Review/Update February 18th, 2016 Clinical Policy Bulletin:Bathroom and Toilet Equipment and Supplies
Number: 0429
Policy Aetna's HMO-based and health network plans (HMO, QPOS, Health Network Only, Health Network Option, Golden Medicare, and U.S. Access) generally follow Medicare's criteria for durable medical equipment (DME) items that are used in the bathroom. Most DME items used in the bathroom are ... February 13th, 2015 Chiropractic Services - Aetna Clinical Policy Bulletin| Published February 13th, 2015 - Last Review/Update March 1st, 2016 AETNA
Clinical Policy Bulletin: Chiropractic Services
Number: 0107
http://www.aetna.com/cpb/medical/data/100_199/0107.html
Policy
Note: Some plans have limitations or exclusions applicable to chiropractic care. Please check benefit plan descriptions for details.
Aetna considers chiropractic services medically necessary when all of the following criteria are met:
The member has a neuromusculoskeletal disorder; and
The medical necessity for treatment is clearly documented; and
Improvement is ... December 19th, 2014 Medicare Parts C & D Fraud, Waste, and Abuse Training and General Compliance Training| Published December 19th, 2014 - Last Review/Update March 1st, 2016 All persons who provide health or administrative services to Medicare enrollees must satisfy general compliance and FWA training requirements. This module may be used to satisfy both requirements.
This training module consists of two parts:
(1) Medicare Parts C & D Fraud, Waste, and Abuse (FWA) Training and Compliance
Objectives:
Meet the regulatory requirement ... July 31st, 2014 CMS has announced a new Provider Relations Coordinator| Published July 31st, 2014 - Last Review/Update January 25th, 2017 07/08/2014 CMS has announced a new Provider Relations Coordinator, Latesha Walker. Latesha is your point of contact for RAC audits. Medicare will do no additional RAC reviews under the current contract; they are making changes to improve the current program. The final date Auditors sent claim adjustment files to Medicare ... July 8th, 2013 Denials for 97140 (Manual Therapy)? Here's the story.| Published July 8th, 2013 - Last Review/Update January 27th, 2017 The ChiroCode Institute has received several inquiries over the last few months regarding a denial for 97140 (Manual therapy—such as myofascial release or trigger point therapy) when billed with 98940-98942 (Chiropractic Manipulative Treatment - CMT) on the same visit. Most payers follow Medicare’s guidelines for the use of this code, ... Aetna TipsAccess to this feature is available in the following products:
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