![]() ![]() It does not mean precertification as defined by Texas law, as a reliable representation of payment of care or services to fully insured HMO and PPO members. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage.Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". In the event that a member disagrees with a coverage determination, member may be eligible for the right to an internal appeal and/or an independent external appeal in accordance with applicable federal or state law. Medical necessity determinations in connection with coverage decisions are made on a case-by-case basis. Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. The member's benefit plan determines coverage. The 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) for a particular member. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Members should discuss any matters related to their coverage or condition with their treating provider.Įach benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Treating providers are solely responsible for medical advice and treatment of members. The ABA Medical Necessity Guide does not constitute medical advice. The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. If you were enrolled in Masterpass™ by Mastercard® you have been automatically upgraded to this service.By clicking on “I Accept”, I acknowledge and accept that: This new online checkout option lets you store all your payment information in one secure payment profile and check out in just a few clicks. Now you can use your card to pay faster and smarter online – no more passwords to remember or accounts to create. Your payment is made digitally without having to insert your card or input account information over and over.ĭepending on your mobile device, you can enroll your smartphone, tablet or smartwatch in its appropriate wallet and input your credit card information to make quick, secure or in-app purchases. Then at check out just tap your phone or click submit. It’s easy! Just input your account information into a digital wallet, payment service or online account. Use digital devices to pay for something fast and securely. Simplify everyday purchases and payments. ![]()
0 Comments
Leave a Reply. |