Learn More. The Peer-to-Peer request must be received by Maryland Amerigroup maryland prior authorization Care within two 2 business days of the initial notification of the denial. The intent of the Peer-to-Peer is to discuss the denial decision with the ordering clinician or attending physician. For specific details prioe authorization requirements, please refer to our Quick Reference Guide. Certain carefirst mental providers require prior authorization regardless of place of service.
Determine if a plan requires prior authorization or notifications or referrals, download digital ID cards and find any additional coverage available. Reconsideration Form This form is to be completed by physicians, hospitals or other health care professionals for paper Claim Reconsideration Requests for our members. Eligibility and benefits interactive guide Interactive guide: Use the UnitedHealthcare Provider Portal to verify member eligibility, determine benefits, view care plans, get a digital copy of member ID cards and more.
Health care professionals can get detailed patient benefit and claims information and access to trainings designed to help you and your practice. Drug Lists and Pharmacy Information related to pharmacy coverage decisions based on an understanding of how health plan coverage affects total member health care including drug lists, supply limits, step therapy, and infusion care. Cancer Therapy Pathways Program The program is intended to improve quality and value in cancer care by supporting the use of therapies supported by evidence-based guidelines to improve outcomes.
Cancer Support Program This program focuses on supporting cancer patients who are at high risk for complications and side effects associated with their cancer or treatment and would benefit from the support of our experienced, specialized cancer nurses.
We want to help your practice build your telehealth capabilities and support your telehealth journey. Maternity Support for UnitedHealthcare Community Plan Members These resources are especially tuned to skilled nursing facilities, including brochures for patient education, support for billing and reimbursement, and a special focus on Medicare Advantage and the UnitedHealthcare Passport Service. Worksite Wellness Health Screening Offered to our Commercial market, the program is an employer-sponsored biometrics screening available to employees, spouses and dependents.
Participants may receive incentives for completing the screening and achieving certain biometric results. Learn more. Please sign in to use Codespaces. If nothing happens, download GitHub Desktop and try again.
If nothing happens, download Xcode and try again. There was a problem preparing your codespace, please try again. If workflow. The function must return a configuration. Webpack dev server port. If the port at this value is unavailable, the port value will be incremented until an unused port is found.
Default: Allows Webpack log levels presets to be used during development. Allows Webpack infrastructure log levels to be set during development. Webpack devtool setting. Default is source-map. Enable or disable Fast Refresh using react-refresh. Default is true. Optional options for Webpack development server. If undefined, workflow defaults are used. When starting the dev server using production settings as a dry run, yarn start --dry-run , the dev server will need to be told where to serve bundled content from:.
Customize any available jest configuration option. Uses lodash merge to deeply merge user config object with defaults. Allows developers to override the webpack target to match their developer environment.
If your project's package. Enable experimental Webpack 5 features in your configurations. Create globals to be used for feature flags. Globals must be defined in the workflow configuration file before they can be used as flags by a project. Mock server port number. If the port is unavailable, a random available port will be used.
Note: we will automatically update the proxy settings to reflect the port used in the case of a random port being selected. Folder that contains the mock data files json, images, etc. Path to route configuration file used by Mock server to build Express routes.
Array of NPM module names that enhance mock server with additional data and routes. Array of proxy configurations. A default configuration is enabled to proxy requests to the mock server. Each proxy configuration can have the following attributes. When true :. The function will be invoked with the current webpack configuration object and a reference to the workflow settings. Change to the directory you want to upgrade the workflow for and run the below command.
Please reference the Webpack 5 migration guide to familiarize yourself with the possible issues and changes needed to complete a migration for your project. Please see this section from the Webpack 5 migration guide. In this example our runtime error references process. Running the command yarn why vfile in our project directory will tell us why we have this dependency. We can see above that vfile is required by react-markdown , now we need to find out why react-markdown is required.
Running yarn why react-markdown in our project gives the following results:. If the runtime error is determined to be coming from an Availity package, please let us know by opening an issue and adding relevant information about which dependencies of that package are causing the issue. We will then be able to determine if we can refactor away from the offending dependency or provide a polyfill for the missing code.
This will vary on a case by case basis, but in general you will want to try and either refactor away from the dependency causing the issue, or provide a polyfill if one has not yet been provided from this repo. Since the runtime error noted that process. To do that, we will add the necessary dependencies and modify our webpack configuration for the project. Now the runtime issue has been resolved! Note that this only polyfills process for the one package that needs it, instead of all packages.
Some packages may rely on the existence of process to determine what type of environment they are running in, in those cases we probably wouldn't want to make process available to them.
Documentation for imports-loader. Link to specific vfile issue and solution.
Single Sign-On The Single Sign-On offers healthcare professionals an easy and secure way to access the provider portals of major local health plans and hospitals as well as other valuable online services. Admin Account Login.
Consensus Recommendations. Contracting for HIE Services. Clinical Data Repository The Clinical Data Repository CDR is designed to simplify access to clinical history and provide a longitudinal view of an individual's patient record. The CDR is now open for testing. Disputes and appeals. Cost estimator and fee schedules. Pharmacy claims. Dental claims. Pharmacy services. Update pharmacy data. Find prescription drug coverage. Clinical policy bulletins.
Clinical policy bulletin overview Medical clinical policy bulletins Dental clinical policy bulletins Pharmacy clinical policy bulletins. Medicare resources. Education, trainings and manuals. Overview Educational webinars Provider manuals Behavioral health trainings. State regulations Federal regulations. News and Insights. OfficeLink updates newsletter. Company news. Existing health care professionals Availity provider portal Update your data Utilization management Provider referral directory.
Pharmacy Pharmacy services Update pharmacy data Find prescription drug coverage. Resources Clinical policy bulletins Clinical policy bulletins Clinical policy bulletin overview Medical clinical policy bulletins Dental clinical policy bulletins Pharmacy clinical policy bulletins.
Education, trainings and manuals Overview Educational webinars Provider manuals Behavioral health trainings. Regulations State regulations Federal regulations.
Digital authorization status letters PDF Clinical questionnaire When you submit a prior authorization request for certain services, we may pend your request for additional clinical information. All the tools you need, all in one place.
All the tools you need, all in one place The Aetna provider portal on Availity helps you spend less time on administration so you can focus more on patient care. You get a one-stop portal to quickly perform key functions you do every day You can: Submit claims Get authorizations and referrals Check patient benefits and eligibility Upload medical records and supporting documentation File disputes and appeals Update your information You can also stay up to date with the latest applications, resources and news from us.
How to get started. How to get started If your practice already uses Availity, simply contact your Availity administrator to request a username. Set up Availity account Need help registering for Availity?
Browse tips, webinars and training to get on board. Availity registration resources. Working with Aetna educational webinars. Register for a live webinar. Availity portal resources and educational materials. Refer to these helpful resources to better navigate Aetna functionality on Availity. Need help? 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. See all legal notices. You are now being directed to the AMA site Links to various non-Aetna sites are provided for your convenience only. You are now being directed to the Give an Hour site Links to various non-Aetna sites are provided for your convenience only.
You are now being directed to the CDC site Links to various non-Aetna sites are provided for your convenience only. You are now being directed to the CVS Health site. You are now being directed to the Apple. You are now being directed to the US Department of Health and Human Services site Links to various non-Aetna sites are provided for your convenience only.
Login Please log in to your secure account to get what you need. You are now leaving the Aetna Medicare website. Error or missing data. Please check your entries for an error message.
This search uses the five-tier version of this plan Each main plan type has more than one subtype. I Accept. I accept. 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. 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.
Not all plans are offered in all service areas. All services deemed "never effective" are excluded from coverage. 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.
Visit the secure website, available through www. CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures performed by physicians. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Aetna Precertification Code Search Tool. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT.
You, your employees and agents are authorized to use CPT only as contained in Aetna Precertification Code Search Tool solely for your own personal use in directly participating in health care programs administered by Aetna, Inc.
Disclaimer of Warranties and Liabilities. Treating providers are solely responsible for dental advice and treatment of members. While the Dental Clinical Policy Bulletins DCPBs are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. 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.
Aetna's 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. Your benefits plan determines coverage. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State or the Federal government.
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. Under certain plans, if more than one service can be used to treat a covered person's dental condition, Aetna may decide to authorize coverage only for a less costly covered service provided that certain terms are met.
Aetna Clinical Policy Bulletins CPBs are developed to assist in administering plan benefits and do not constitute medical advice. Members should discuss any Clinical Policy Bulletin CPB related to their coverage or condition with their treating provider.
While the Clinical Policy Bulletins CPBs are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. The Clinical Policy Bulletins CPBs express Aetna's determination of whether certain services or supplies are medically necessary, experimental and investigational, or cosmetic. Aetna has reached these conclusions based upon a review of currently available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors.
Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins CPBs. 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.
May 11, аи Availity Portal login issues If you cannot log in to Availity Portal, browse these questions and answers for the solution to your problem: Does Availity provide any self-service . The Aetna provider portal on Availity helps you spend less time on administration so you can focus more on patient care. You get a one-stop portal to quickly perform key functions you do . The Availity Portal offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. Use the secure Availity Portal .