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. Substance abuse treatment - use phone number on member's ID cardīy clicking on “I Accept”, I acknowledge and accept that:.
#Open dental customer service registration
#Open dental customer service software
Claims, payment & reimbursement overview The RMM Software That Puts the Power of Automation in Your Hands.Patient care programs & quality assurance.The user assumes all risk and liability in connection herewith. Before using, it is the responsibility of the user to determine the suitability of the product for its intended use. does not accept liability for any damages or loss, either direct or consequential, stemming from the use or inability to use the products as described.
recognizes it’s a responsibility to replace products if proven defective. Any item returned after 30 days will be subject to a restocking fee. We have a 30-day return policy from the date of receipt. To ensure proper credits, please return the product in its entirety along with the return authorization number and a written reason for the return. If you are not completely satisfied with any product, please call us at 1.800.835.0885 within 30 days from the date of receipt for a return authorization number. Expedited shipping is available for an additional charge. We require a minimum order of $100.00 (USD). (Additional $5.00 charge will be applied to all C.O.D. We accept American Express, MasterCard, Visa, Check or C.O.D. Until credit is established, all orders must be prepaid. The site contains our catalog as well as technical data and product updates. We may also be accessed on the world wide web.
Our hours of operation are Monday through Friday 8:00am to 5:00pm CST. Save your practice time and money through claims processing, attachments, and encrypted email. We maintain a toll-free phone, and e-mail service for our customers’ convenience. Vyne Dental provides easy-to-use software that simplifies the process of claims and attachment management, facilitates secure communications, speeds up payments, and helps your practice thrive.