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Our office manual keeps you informed

 

Visit us online to view a copy of your Office Manual for Health Care Professionals (PDF). This Aetna® office manual also applies to the following joint ventures: Allina Health | Aetna, Banner|Aetna, Texas Health Aetna, and Innovation Health.

 

If you don’t have Internet access, call our Provider Contact Center at 1-888 MD AETNA (1-888-632-3862) (TTY: 711) to get a paper copy.

 

What’s in the manual

 

The manual contains information on the following:

 

  • Policies and procedures
  • Patient management and acute care
  • Our complex case management program and how to refer members
  • Additional health management programs, including disease management, the Aetna Maternity Program, Healthy Lifestyle Coaching and others
  • Member rights and responsibilities
  • How we make utilization management decisions, which are based on coverage and appropriateness of care, and include our policy against financial compensation for denials of coverage
  • Medical Record Criteria, which is a detailed list of elements we require to be documented in a patient’s medical record and is available in the Office Manual for Health Care Professionals (PDF)
  • The most up-to-date Aetna Medicare Preferred Drug Lists, Commercial (non-Medicare) Preferred Drug Lists and Consumer Business Preferred Drug Lists, also known as our formularies

 

How to reach us

 

Our medical directors are available 24 hours a day for specific utilization management issues. Contact us by visiting our website, calling the Provider Contact Center at 1-888 MD AETNA (1-888-632-3862) (TTY: 711) or calling the patient management and precertification staff using the Member Services number on the member’s ID card.

 

More information

 

Visit us online for information on how our quality management program can help you and your patients. We integrate quality management and metrics into all that we do, and we encourage you to take a look at the program goals.

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.

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