Virginia Find out how to check the status of a VA claim or appeal online. VHA Office of Integrated Veteran Care ATTN: SB Claims PO Box 30750, Tampa FL 33630-3750 Contact It is only a partial, general description of plan or program benefits and does not constitute a contract. 8:05 a.m. to 6:45 p.m. ATTN: Appeals. or https:// means youve safely connected to the .gov website. Call: 877-CCN-TRIW (226-8749) Monday Friday. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. You can use Availity to submit and check the status of all your claims and much more. To use TeleTYpe for the Molina Healthcare & Vendors Contact Information. Address VA Form 21-4142 was developed in consultation with the Department of Health and Human Services component responsible for the HIPAA Privacy Rule. VA: 800-842-5975 877-228-7268 (National Service Accounts - NASCO) 202-488-4900 (Federal Employee Program - DC/Metropolitan area) 800-854-5256 (Federal Employee Program - MD) 800-676-2583 (BlueCard - Eligibility) 877-228-7268 (BlueCard Out of Area Claims - Eligibility) Washington: 800-722-4714 888-261-9562 (Premera Blue Call: 988 (Press 1), U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. To get started, go to UHCprovider.com and click Sign In in the top right corner. Links to various non-Aetna sites are provided for your convenience only. Box 8470 St. Thomas, Virgin Islands 00801 *Washington Premera Blue Cross (WA/AK) Call: 988 (Press 1), U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. Learn about Veteran community care. The length of time it takes to complete a claim depends on several factors, such as the type of claim filed, complexity of your disability(ies), the number of disabilities you claim, and the availability of evidence needed to decide your claim. Thats why Anthem uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. CPT is a registered trademark of the American Medical Association. Hours: Monday through Friday, If you believe a claims agent or attorney charged a fee thats too high, you can challenge it. WebPhone. They will get you the answer or let you know where to find it. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. WebBoth the old and new cards will enable claims processing. If you are a member, log in for personalized contact information. If you are in crisis or having thoughts of suicide, Please ensure both the billing address and the physical address where services were actually provided are on the claim submission. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. Careers; Accessibility; Hours: Monday through Friday, VA CCN providers can call CCN Provider Services from 8 a.m. 6 p.m. providers local time, You can now get what you need without thumbing through volumes. Web All other Provider Enrollment inquiries Virginia Medicaid Provider Enrollment Helpdesk Phone 804 270 5105 or 888 829 5373 -804 270 7027 or 888 335 8476 Email: Va.Medicaid.ProviderEnrollment@conduent.com Web Systems (8am-5pm, Mon-Fri) Phone Web Registration (new and registered providers) You can track the status of your claim by registering for eBenefits at www.ebenefits.va.gov. But despite these challenges, we know the reward is worth the effort. TTY 866-690-0891: Our Contact Centers accommodate Hours: Monday through Friday, A witness signature is not required by Federal law. WebProvider Contact Information. Claims Use the secure app on the Availity 3829 Gaskins Road Richmond, VA 23233. Box 469065 Denver, CO 80246-9065 WebThe Department of Veterans Affairs runs programs benefiting veterans and members of their families. VHA Office of Integrated Veteran Care. Please keep the following in mind when submitting paper Claims: SSI Claimsnet Customer Service: 800-356-0092. The https:// ensures that you're connecting to the official website and that any information you provide is encrypted and sent securely. Box 211241 Eagan, MN 55121 Electronic claims Payer ID: 82832 Find out how to get free language assistance from VA. Our FAQs, step-by-step guides, and other resources can help answer specific questions you may have about these topics: Explore our resources and support content. Payer Aetna. Health Care Claims Status (277Health Care Claim Status Response), Health Care Services Review (278Response to an EDI Health Care Services Request for Review), Eligibility Status (271Health Care Eligibility Benefit Response), Response to Service Type Code 30 or Explicit Service Type Inquiries, Patient Responsibility for Individual and Family including deducible amounts, co-insurance amounts, and catastrophic cap. These vans and trucks will move from one location to another to provide a private space for eligible Veterans to meet with medical providers including mental health clinicians, social workers, and other staff that provide primary care, womens health, audiology, laboratory, and telehealth services. If youre filling out one of the forms, youll need to mail it to your nearest VA regional office. They can help you with VA-related needs. GI Bill or other education benefits. WebWhether you need to report an insurance claim or you're looking for claims information, it's all right here. VHA Office of Community CareATTN: Spina Bifida Health Care Benefits ProgramP.O. Before submitting your claim, make sure the type is not offset and all items are in the correct fields. Box 26803 Richmond, VA 23261-6803. We trust these professionals because theyre trained and certified in the Call: 988 (Press 1), U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. If you have questions related to COVID-19, including those on our telemedicine policy, testing, coding for COVID-19 related visits, and additional resources Aetna is sharing to support you during this pandemic, please check our COVID-19 provider website. Find phone numbers for many of the administrative and program offices at VA Central Iowa health care. Phone directory and mailing address. Behavioral health P.O. 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. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Box 31364 Salt Lake City, UT 84131-0364. Box 105557. IMPORTANT: Community providers cannot receive payment for care provided to Veterans through a VCA until the VCA is established and signed. Claim For specific details regarding filing limits for the claim types listed below, review the Mailing Addresses The .gov means its official. Torequest participation in First Health networks, follow the link below. Contact Health Net Claims Aetna Address; Mailing address: PO Box 14088 Lexington, KY 40512: Request a Medical coverage decision by Mail: Medical Service: PO Box 14079 Lexington, KY 40512-4079: Request a Medical Appeal by Mail: Aetna Medicare Part C Appeal and Grievances PO Box 14067 Lexington, KY 40512: Request a Drug Coverage decision by To enter and activate the submenu links, hit the down arrow. If you have 90 to 180 days left on active duty, find out how to file a disability claim through the Benefits Delivery at Discharge (BDD) program to get your benefits sooner. Box 4444 Janesville, WI 53547-4444. WebAll Excellus plans use this mailing address: Excellus BCBS Attn: Claims P.O. WebPlease visit the WPS Military and Veterans Health customer service page for contact information related to TRICARE4u and TRICARE For Life claims and messaging, or call 866-773-0404 for assistance. Chat with a live agent. VA provides care to Veterans through community providers when VA cannot provide the care needed. WebMail. For more details on our new provider portal, visit our Family Care Providers or our CLTS page. WebMailing Addresses/Fax Numbers. Find out how to change your address and other contact information in your VA.gov profile. WebVirginia Beach, VA 23466-1010 Electronic claims https://www.availity.com Payer ID: SMPLY Claims for a date of service prior to May 1, 2021, should be sent to Miami Childrens electronically or by mail. ET. 8:00 a.m. to 6:00 p.m. Go to eBenefits to find a local representative (including a recognized VSO, an attorney, or a claims agent) by state/territory, zip code, or the organizations name. I practice independently and I want to contract with Aetna. Dental Claim Form Completion Aide. U.S. Department of Veterans AffairsFinancial Services CenterP.O. The information you will be accessing is provided by another organization or vendor. WebSubmitting Paper Claims. VSOs work on behalf of Veterans and service membersas well as their dependents and survivors. 3. Helpful VA Phone Numbers | Veterans Affairs Hours: Monday through Friday, WebInteractive Guide: Use the UnitedHealthcare Provider Portal to view claim status, take action, if needed, check the status of tickets and more. About VA Form 20-0995. Office of Accountability & Whistleblower Protection, Training - Exposure - Experience (TEE) Tournament, Outreach, Transition and Economic Development Home, Warrior Training Advancement Course (WARTAC), Staff Appraisal Reviewer (SAR) Information, How to Apply for Nonsupervised Automatic Authority, VALERI (VA Loan Electronic Reporting Interface). have hearing loss, Civilian Health and Medical Program of Veterans Affairs (CHAMPVA), Camp LeJeune Family Member Program (CLFMP), Children of Women Vietnam Veterans (CWVV) Health Benefits Program, Spina Bifida Health Care Benefits Program (SBHCBP), Pharmacy benefits for CHAMPVA, CWVV and SBHCBP, Durable Medical Equipment (DME) worth more than $2000, Most mental health or substance abuse services. Go to the American Medical Association Web site. To help us direct your question or comment to the correct area, please select a category below. Contact Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. To enter and activate the submenu links, hit the down arrow. OptumRx Pharmacy Help Desk: 888-546-5503. Providers Mail to: DEPARTMENT OF VETERANS AFFAIRSCLAIMS INTAKE CENTERPO BOX 4444JANESVILLE, WI 53547-4444, or Fax to: TOLL FREE: 844-531-7818 & 248-524-4260 (Utilized for Foreign Claimants), Veterans Crisis Line: visit VeteransCrisisLine.net for more resources. Contact visit VeteransCrisisLine.net for more resources. Apply for and manage your GI Bill and other education benefits to help pay for college and training programs. Press enter on the item you wish to view. Email: claims@apriltravelprotection.com. WebVA Community Care Network. ET, +1-918-781-5678This isnt toll-free. It offers education opportunities and rehabilitation services and provides You must submit electronic claims through our clearinghouse, Change Healthcare (formerly Emdeon). Links to various non-Aetna sites are provided for your convenience only. 8:00 a.m. to 8:00 p.m. Apply for VA health care, find out how to access services, and manage your health and benefits online. WebContact us today if you have questions or need information. You can use Availity to submit and check the status of all your claims and much more. WebVA Community Care Network Claims Management Instructions for filing electronic and paper VA CCN claims are in the VA CCN Provider Manual, available at provider.vacommunitycare.com > Training & Guides. Mailing Addresses To use TeleType (TTY) services: By law, CLFMP is always the last payer. Community Care Network Contact CenterProviders and VA Staff Only. 7700 Arlington Boulevard Suite 5101 Falls Church, VA 22042-5101. Contact our Credentialing Department to become a participating provider. Ask VA (AVA) is our online tool that replaced the Information Routing & Inquiry Service (IRIS) and the GI Bill Help Portal. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Box 31364 Salt Lake City, UT 84131-0364. WebMailing Instructions: All Decision Point Review, pre-certification and internal appeals related documents are to be submitted to: Premier Prizm Solutions, LLC 10 East Stow Road Suite 100 Marlton, New Jersey 08053 Phone Number: 856-596-5600 Fax Number: 856-596-6300 Email Address AICRA@PremierPrizm.com EP0052(08-12) Contact the PGBA EDI Help Desk at 1-800-259-0264, option 1 or by email at PGBA.EDI@pgba.com. Payspan or portal issues should be directed to your Provider Service Rep for your area. QTC Management, customer service number 800-682-9701. Veterans Affairs We also reimburse qualified family members as the last payer of medical claims for these 15 conditions. In person. WebFor provider enrollment inquiries, contact the Virginia Medicaid Provider Enrollment Helpdesk by phone at 804-270-5105 or 888-829-5373. Find the phone number to call for the help you need. It is common for claims to return to this phase, should additional evidence be required. Submitting only the secondary explanation of benefits could delay processing or cause a denial of payment for your claim. Box Paper ClaimsWe encourage you to submit claims electronically for CLFMP. Click "Enter", You should see a split table. Box 52890 But they may charge you for unusual expenses. VA Form 21-4142 is designed specifically to: Click here to view or fill out VA Form 21-4142. Important: The mailing address below only pertains to The recommended decision is reviewed, and a final award approval is made. Request a medical application. 2. For non-English speakers:Select 0 to connect to a call center agent. 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. Family members who receive care through the CHAMPVA program, the Children of Women Vietnam Veterans program, or the Spina Bifida Health Care Benefits Program can access pharmacy benefits through the Meds by Mail program, or by visiting a pharmacy in the OptumRx network. EFT/check number. 8:00 a.m. to 9:00 p.m. Contact GEICO A written statement explaining your disagreement must be received within one year from the date of notification. EINs that include additional digits or alphas can slow the processing of claims and even cause payment to be submitted to an incorrect provider. For PC3/Choice providers with concerns, please first contact Health Net and TriWest directly. I am a non-physician health care professional who wants to be available for selection as a primary care provider (PCP), and my state regulations allow me to serve as a PCP. TRICARE West Claims Submission Health Net Federal Services, LLC c/o PGBA, LLC/TRICARE P.O. Form last updated:April 2023. Contact Us Contact Applications are available at the American Medical Association Web site, www.ama-assn.org/go/cpt. Related to:Decision reviews and appeals. Box 469065, Denver CO 80246-9065. Contact Here you can find the VA Accredited representatives and VSOs can help you understand and apply for VA benefits, like these: These trained professionals can also help in these ways: Note:If your claim has a clear factual or legal error, your accredited representative orVSOcan request a faster Higher-Level Review decision through a new pilot program called Claim Accuracy Request (CAR). I may or may not be employed by an Aetna-contracted provider. To access the menus on this page please perform the following steps. WebClaims & medical records P.O. Dental claims must be filed filed via 837 EDI transaction or using the most current American Dental Association (ADA) form and comply with ADA and specific, VA requirements listed below. Spina Bifida Health Care BenefitsInformation for Providers. If you should have portal concerns and need technical support, then you can contact 1-877-814-9909. b. WebContact Pharmacy Benefits. 8:00 a.m. to 8:00 p.m. Contact 7:30 a.m. to 7:00 p.m. WebME, MI, MN, NC, ND, NE, NH, OK, OR, RI, SC, SD, VA, VT, WA, WI, WY Dentegra Insurance Company; AK, CT, DC, DE, FL, GA, KS, LA, MS, MT, TN, WV Delta Dental Insurance Company; HI, ID, IL, IN, KY, MD, MO, NJ, OH, TX Alpha Dental Programs, Inc.; NV Alpha Dental of Nevada, Inc.; UT Alpha Dental of Utah, Inc.; NM Alpha The new cards will include information about claims processing and contact information for members and providers. If the patient has Other Health Insurance (OHI) coverage, the OHI should be billed first. Attachment Mailing Address PO Box 981106 El Paso, TX 79998-1106. Use eBenefits to let us know youll be working with a representative or to change your current representation. We need to be coordinated with our community partners, said Eileen Devine, former national director for Health Care for Homeless Veterans (HCHV). Contact Us | Veterans Affairs TriWest is pleased to offer options to help callers with hearing or speech disabilities communicate telephonically. Paper claims should also have WebBy mail You can also mail hard copy claims or resubmissions to: Aetna Better Health of West Virginia. It offers education opportunities and rehabilitation services and provides compensation payments for disabilities or death related to military service, home loan guaranties, pensions, burials, and health care that includes the services of nursing Whether youre a member or provider Amerigroup is here for you. Links to various non-Aetna sites are provided for your convenience only. Hours: Monday through Friday, Send paper claims to: VHA Office of Community CareATTN: CWVV Health Care Benefits ProgramP.O. Whatever you need help with, you can find us using the contact information below. 11900 Biscayne Blvd, Suite 600. However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. 2. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. WebQ13: What if I still have questions regarding EDI for VA CCN? Our Payer ID number is 84146 for medical claims and visit VeteransCrisisLine.net for more resources. MediCall - Automated Voice Response System. The Veterans Service Representative will request evidence from the required sources. Applicable FARS/DFARS apply. Find your provider representative. FAQ. Im proud that were now able to provide more Veterans with the care they need and deserve, despite the barriers that stand in our way. MAIL CLAIMS TO: AETNA P.O. This Provider Handbook applies to the Department of Veterans Affairs (VA) Community Care Network (CCN) for TriWest Healthcare Alliance (TriWest) network providers in Regions 4 and 5. New Cardinal Care Plan First ID cards will clearly Provider termination form and directory update. To help address the obstacles homeless Veterans face in accessing medical care, VAs Homeless Patient Aligned Care Teams (HPACTS) have provided 25 select It is very important that you provide your physical address, even if you utilize a separate mailing address. Independent non-retail pharmacies - such as long-term care facilities, home infusion pharmacies, and mail order pharmacies - can call one of the phone numbers below to request participation: Chain or PSAO pharmacies can request to participate in our Part D retail pharmacy network by emailing us this information: E-mail your pharmacy information to Aetna. The responsibility for the content of Aetna Precertification Code Search Tool is with Aetna and no endorsement by the AMA is intended or should be implied. Veterans Affairs FSGLI: Family Servicemembers Group Life Insurance, Schedule of Payments for Traumatic Losses, S-DVI: Service-Disabled Veterans Life Insurance, Beneficiary Financial Counseling and Online Will, Lesbian Gay, Bisexual & Transgender Veterans, Pension Management Center (PMC) that serves your state, Claims Adjudication Procedures Manual/Live Manual, Link to subscribe to receive email notice of changes to the Live Manual. 2. ET, 855-829-6636 Some payments are made based on specific clinical guidelines. Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". Find phone numbers for many of the administrative and program offices at VA Wilmington health care. All Rights Reserved. ET, 888-442-4551 have hearing loss. Contact 8:00 a.m. to 9:00 p.m. Reminder: To register for access to the provider portal, you need the following information from two of your remittances from the past 90 days: Claim number.
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