For the PHCS Network, 1-800-922-4362 For PHCS Healthy Directions, 1-800-678-7427 For the MultiPlan Network, 1-888-342-7427 For the HealthEOS Network, 1-800-279-9776 For language assistance, please call 1-866-981-7427 For TTY/TTD service, please call 1-866-918-7427 Search for a provider > Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Last week, the D.E.A. Members should discuss any Dental Clinical Policy Bulletin (DCPB) related to their coverage or condition with their treating provider. All Rights Reserved. Our payer partner Lucent Health has a new way to check eligibility and verify benefits. Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. The medicine can rapidly reverse an opioid overdose and is often available at local pharmacies without a prescription. For information on these Medicare benefits, visit our Extra Benefits page. Dr. Fiellin, the Yale physician, said that some doctors in the training sessions he held for X waivers perceived a stigma associated with the medication. that shall look like "Welcome (Your name here)", "Logged In Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. Lucent Provider Portal. License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Previously, Tina was an Account Executive at Cottingham & Butler, was a Client Services Account Manager at Willis Towers Watson, and held various leadership positions at Humana for 15+ years. Need help, please call (844) 848-6089, or email support by clicking HERE . For contracted providers and facilities, Network Health (NH) obtains provider's data, (i.e., name, gender, office location, board certifications, specialty, hospital affiliations, medical group affiliations, accepting new patients, and languages spoken) on the credentialing application and validates it every three years as part of the re-credentialing process. Listed on 2023-03-03. Aetna defines a service as "never effective" when it is not recognized according to professional standards of safety and effectiveness in the United States for diagnosis, care or treatment. For qualifying patients, we will also arrange for transportation. You are now being directed to CVS Caremark site. Please email CA.ITHelpDesk@lucenthealth.com if you have forgotten your username or need to have your password reset. More Doctors Can Now Prescribe Buprenorphine to Opioid Users. Will It The responsibility for the content of Aetna Clinical Policy Bulletins (CPBs) is with Aetna and no endorsement by the AMA is intended or should be implied. personalized for your account or display the primary data you work In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government. . Instead of signing up for another year of increasing costs and poor member experiences, he created a better way. Treating providers are solely responsible for medical advice and treatment of members. Generally, you will get your health care services from your personal doctor. Health Care Providers. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Clay joined Lucent Health in 2014 and has extensive experience working with health plan benefit designs, physician and hospital contracting, pharmacy formulary management, care management, reference-based pricing and value-based payment plans. Lucet puts smart technology and human expertise to work to transform behavioral healthcare. only those credentials to sign in to the portal. Employer. If you think someone is overdosing, call 911 right away. Until December, doctors who went through the process of acquiring a waiver still faced a cap on how many patients they could treat with the medication at once. For improving access, it may be that removing the X waiver helps, but it may not be sufficient, said Dr. David Fiellin, an addiction physician at the Yale School of Medicine who has trained other doctors pursuing X waivers. While Network Healths Medicare Advantage PPO plans allow members to see in- and out-of-network providers, physicians and facilities, unfortunately, Mayo Clinic has indicated they will no longer see some Medicare Advantage members. No third party may copy this document in whole or in part in any format or medium without the prior written consent of ASAM. LIN | Login - Ebix resolve the sign in issue, you must open the official page Visit the secure website, available through www.aetna.com, for more information. Since Dental Clinical Policy Bulletins (DCPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. 18 Tips on Preparing for a Doctors Visit, Why you should have a primary care doctor, When to Switch Doctors: Signs, Tips on Switching, & More. If you are interested in scheduling an appointment, please call (888) 8986762 to speak toanagent. Learn more about Lucent Health Learn More "We are delighted to add Cypress Benefit Administrators to the Lucent Health Solutions platform in creating an innovative preview Lucent Health. Phone: (855) 887-0855 Member. The ABA Medical Necessity Guidedoes not constitute medical advice. Who are Providers? Buprenorphine is one of two effective, commonly prescribed medications for opioid addiction; the other is methadone. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. We believe in a more direct path to better mental health, connecting people to the care they deserve. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Provider If you need more information, please contact our Customer Service Team at 800.895.0621. Lucet | Behavioral Health Services and Solutions Brett has been the CEO of Lucent Health since 2014 and leads the companys strategy and growth initiatives. Use the URL on the member's ID card to register for the portal. Please note also that Dental Clinical Policy Bulletins (DCPBs) are regularly updated and are therefore subject to change. When billing, you must use the most appropriate code as of the effective date of the submission. At Lucent Health, our mission is helping members navigate both the clinical and the economic impacts of healthcare. This information, however, is not an endorsement of a physician or health care professional's suitability for your needs. password that you chose when you signed up U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. WE ARE Human Focused Our "people first" approach delivers better outcomes. For the most up-to-date information, the online search tool is the best resource.). I didnt think my insurance would help me like this. Submitting claims for Aetna Signature Administrators (ASA) plan, Submitting claims for Aetna Signature Administrators plan, Please be sure to add a 1 before your mobile number, ex: 19876543210, Precertification lists and CPT code search, OfficeLink Updates Newsletters Latest News for your Medical Office, Aetna Signature Administrators solution flyer (PDF), The Aetna Signature Administrators name with PPO directly below. The member's benefit plan determines coverage. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. HMO and POS plans underwritten by Network Health Plan. This means you can select any doctor who accepts Medicare beneficiaries. CPT is a registered trademark of the American Medical Association. You will need to choose one of our network providers listed in this directory to be your Primary Care Provider, also known as your personal doctor. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Our doctors spend the time to get to know you and your medical history so they can offer a comprehensive healthcare plan suited to your needs. The five character codes included in the Aetna Clinical Policy Bulletins (CPBs) are obtained from Current Procedural Terminology (CPT), copyright 2015 by the American Medical Association (AMA). Your email address will not be published. Unlisted, unspecified and nonspecific codes should be avoided. It has significant advantages over methadone, which is so restricted that it spawned a Twitter hashtag, #freemethadone. Ive had to rebuild so many times, Mr. Lambert, who works at the rehab site supervising medications for other residents, said on a recent afternoon. lucent health provider portal - Loginma.com She dug deep into the correspondence between the hospital and the insurance company. And even when someone obtains a prescription for buprenorphine, some pharmacies may not dispense it. Need help logging in, please call (844) 848-6089, Username: Password: Toggle navigation COVID-19 Info Now buprenorphine, once highly restricted, is available to far more doctors to prescribe for patients, the result of a significant change in federal drug policy that scrapped a special licensing requirement known as an X waiver. In December, Congress approved the change as part of a government spending package, dramatically expanding the pool of physicians and health workers who could prescribe the medication. Prior to joining Lucent Health, Tina was a Senior Account Executive at Cypress Benefit Administrators, which Lucent Health acquired in 2017. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. Charlene Williams said she used buprenorphine before her doctor stopped working with her. Lucent Provider Portal First Choice Health - For Providers - Fchn.com There may be providers or certain specialties that are not included in this application that are part of our network. Lucent Health | All content on this site is copyrighted by Healthx. If Lucent Health Provider Portal is not working properly, share the problem detail below. 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. The Portals will not work well, or not work at all, with other browsers. Lucet helps people get the care they deserveensuring quality, timely access, and value-driven care for all who need it. After all, youre a person, not a number. Please submit all IDR inquiries to:LucentIDR@lucenthealth.com, Thank you for your message. Heres more of our story of how we built a company that would be a better health benefits partner to self-insured employers. CPT only copyright 2015 American Medical Association. Buprenorphine is often given under the brand name Suboxone, which is administered in small orange strips under the tongue. Schedule time with one of our providers to start getting the care YOUdeserve. We want to make sure our members can get the high-quality care they need with providers, physicians and facilities that work collaboratively with us to ensure the best possible health care experience. Our providers spend time listening to your needs so they can put together a comprehensive medical plan tailored to you, not someone else. Some lawmakers have suggested that the removal of the X waiver requirement could lead to poorly trained physicians making uninformed prescribing decisions, or the misuse or sale of the medication. Y0108_4280-01-0922_2023_D To learn more, see the Aetna Signature Administrators solution flyer (PDF). Need a username and password? New Directions Behavioral Health and Tridiuum are now Lucet. Looking for the member website? How do I or a family member become an Oak Street Health patient? Director, Clinical Quality and Patient Enrollment, Corporate Headquarters Primary care centers &clinics accepting Medicare. With her drug use under control on buprenorphine, she was looking for jobs. Stick to licensed pharmacies. I stay, I hug, I hold, she said, describing her bedtime routine with her daughter. 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. But addiction experts warn that lifting the buprenorphine restrictions may not prove to be a panacea. The discussion, analysis, conclusions and positions reflected in the Clinical Policy Bulletins (CPBs), including any reference to a specific provider, product, process or service by name, trademark, manufacturer, constitute Aetna's opinion and are made without any intent to defame. (Printed directories are only as current as the date indicated on the directory. CPBs include references to standard HIPAA compliant code sets to assist with search functions and to facilitate billing and payment for covered services. https://mylucenthealth.com/lucentprovider. You can check the current accreditation status of hospitals by visiting the following sites: If you would like assistance or want a provider or facility directory mailed to you, please call us at 800-769-3186. to resolve disputes regarding plan out-of-network payments for emergency services provided by nonparticipating providers/facilities/air ambulances and for non-emergency services furnished by certain nonparticipating providers/facilities at participating healthcare facilities. reached record highs in the United States in 2021, drugs sold online or by unlicensed dealers, proposed that after the pandemic public health emergency is lifted, lacked buprenorphine-prescribing physicians, safe to sell over the counter without a prescription, By far the largest factor is drug overdoses, mostly from fentanyl. The pages are provided for your information and guidance by the Lucent Chapter Benefits Team. Copyright Lucent Nokia All Rights Reserved. Clinically Integrated Partner: Health care provider systems, and the individual providers within those systems, who are in a unique collaborative partnership with Network Health to meet the highest quality care standards and assure members are engaged in their health care. To find an in-network doctor or facility near you,choose a Network Health plan type from the drop down below. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Only take pills that were prescribed by your doctor and came from a licensed pharmacy. Patients must regularly travel to special clinics to receive doses of methadone, even if they are given limited take-home privileges. We also recommend that, prior to seeing any physician, including any specialists and mental health providers, that you call the physician's office to verify their participation status and availability, since a provider's availability to see new patients may change frequently. Clinical Social Worker, Mental Health Worker, Family Support Services. CPT only Copyright 2022 American Medical Association. While every effort is made to ensure that we provide current, accurate data, provider information changes frequently. See what else makes Oak Street Health so unique. How do I find doctors who accept Medicare near me? We accept all forms of Medicare, including Original Medicare Part B, select Medicare Advantage plans, Medicare Supplement or Medigap plans and Medicare-Medicaid Plans. Lucent Health with the customer service number found on your ID card. BBB Business Profiles may not be reproduced for sales or promotional purposes. All services deemed "never effective" are excluded from coverage. It is such a genuine privilege to work with these wonderful professionals. To access the Lucent Health provider portal, you need to register and have an account with them. For help finding an in-network provider, physician or facility, use our Find a Doctor search or call our member experience team at the number on the back of your ID card. We will provide you with information to help you make informed choices, such as physicians and health care professionals' credentials. The obstacles could feel arduous to physicians uncertain about working with opioid users, functioning as a permission structure for avoiding that work in their practices, addiction experts said. solutions. Because we believe that people deserve a more direct path to better mental health. Plus, unlike HMO plans, Network Health does not require a referral from your personal doctor to see specialists. Fentanyl is a potent and fast-acting drug, two qualities that also make it highly addictive. Provider. Anyone can read what you share. For language services, please call the number on your member ID card and request an operator. Required fields are marked *. Some treatment programs and conservative lawmakers have been reluctant to promote buprenorphine, seeing it as swapping one opioid for another. The information you will be accessing is provided by another organization or vendor. A federal process has been established to resolve disputes regarding plan out-of-network payments for emergency services provided by nonparticipating providers/facilities/air ambulances and for non-emergency services furnished by certain nonparticipating providers/facilities at participating healthcare facilities.