![aetna timely filing limit 2018 aetna timely filing limit 2018](https://venturebeat.com/wp-content/uploads/2020/02/Dispatch-Office_1.jpg)
You may ask for this review immediately, but must ask within 60 days after the day the Quality Improvement Organization said no to your Level 1 Appeal. Within 48 hours the reviewers will tell you their decision. If you miss the deadline for contacting the Quality Improvement Organization about your appeal, you can make your appeal directly to us instead. You must contact the Quality Improvement Organization to start your appeal no later than noon of the day after you receive the written notice telling you when we will stop covering your care. You can ask to change this decision so you're able to continue coverage. When your coverage for that care ends, we'll stop paying our share of the cost for your care.
![aetna timely filing limit 2018 aetna timely filing limit 2018](http://secure.tickertech.com/pics/nasdaq/11523282423.gif)
You’ll receive a "Notice of Medicare Non-Coverage (NOMNC)" in writing at least 2 days before we decide it’s time to stop covering your care. (Usually, this means you’re getting treatment for an illness or accident, or you're recovering from a major operation.) Rehabilitation care as an outpatient at a Medicare-approved Comprehensive Outpatient Rehabilitation Facility (CORF).Skilled nursing care as a patient in a skilled nursing facility."We appreciate Aetna's efforts and look forward to continued cooperation on issues that may impact access to care.You have the right to keep getting your covered services for as long as the care is needed to diagnose and treat your illness or injury if you’re getting:
![aetna timely filing limit 2018 aetna timely filing limit 2018](https://sk8wallpapers.files.wordpress.com/2011/08/joey_brezinski.jpg)
"Aetna has been working with APTA to support access to PT services, and understands the importance of making providers aware of how specific policies are interpreted," said Alice Bell, PT, DPT, an APTA senior payment specialist.
#AETNA TIMELY FILING LIMIT 2018 PROFESSIONAL#
State direct access provisions could allow for reimbursement from Aetna without a referral.Īetna’s policy reads that “Aetna considers physical therapy medically necessary when this care is prescribed by a chiropractor, DO, MD, nurse practitioner, podiatrist or other health professional qualified to prescribe physical therapy according to state law." Representatives from Aetna have clarified that in states with direct access provisions for PTs, a PT is considered an “other health professional qualified to prescribe physical therapy,” meaning that PT services will be reimbursed without an order or referral if all other requirements are met. Here's what Aetna said:Įvaluations could be eligible for payments sooner than the 180-day wait period.Īlthough Aetna’s policy reads that "physical therapy evaluations will be eligible for payment once every 180 days," Aetna representatives have informed APTA that evaluations performed within 180 days of the original evaluation may be allowed upon reconsideration or appeal, providing the evaluation is for a new or unrelated condition. The clarifications help to answer questions related to the company's physical therapy policy, specifically around payment for evaluations and the ways direct access provisions can affect payment. Aetna’s corporate coverage guidelines for acupuncture are laid out in Clinical Policy Bulletin. As Acubiller’s benefit team researches policy information for our growing client base, we look for emerging trends in coverage. Major commercial insurer Aetna recently provided some clarification on policies related to payment for physical therapy, and it's good news for physical therapists (PTs) and their patients. Billing techniques, filing requirements, and policy details can (and often do) change dramatically from year to year.