Applies to: Aetna Choice ® POS, Aetna Choice POS II, Aetna Medicare ℠ Plan (PPO), Aetna Medicare Plan (HMO), all Aetna HealthFund ® products, Aetna Health Network Only ℠, Aetna Health Network Option ℠, Aetna Open Access ® Elect Choice ®, Aetna Open Access HMO, Aetna Open Access Managed Choice ®, Open Access Aetna Select ℠, Elect Choice, HMO, Managed Choice POS, Open Choice ®, Quality Point-of-Service ® (QPOS ®), and Aetna Select ℠ benefits plans and all products that may include the Aexcel ®, Choose and Save ℠, Aetna Performance Network or Savings Plus networks.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. 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.
Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. Clear Bags Directions Facilities Photo Galleries Tailgating Ticket Office Wildcat Athletic Association Wildcats Store Athletic Social Media Directory Facebook Instagram Twitter YouTube Prospective Student-Athletes NCAA Division II Tool Kit Guide to FVSU Financial Aid Guide to the College Bound Student-Athlete Initial Eligibility Pamphlet 4-Year Transfer Guide 2-Year Transfer Guide Men's Basketball Women's Basketball Cross Country/Track & Field Football Softball Men's & Women's Tennis Men's Volleyball Women's Volleyball Fort Valley State University Athletic Association, Inc.By clicking on “I Accept”, I acknowledge and accept that: Basketball Basketball: Instagram Basketball: Schedule Basketball: Roster Basketball: News Tennis Tennis: Schedule Tennis: Roster Tennis: News Cross Country Cross Country: Schedule Cross Country: Roster Cross Country: News Football Football: Twitter Football: Instagram Football: Schedule Football: Roster Football: News Track & Field Track & Field: Schedule Track & Field: Roster Track & Field: News Men's Volleyball Men's Volleyball: Facebook Men's Volleyball: Twitter Men's Volleyball: Instagram Men's Volleyball: Schedule Men's Volleyball: Roster Men's Volleyball: News Basketball Basketball: Twitter Basketball: Schedule Basketball: Roster Basketball: News Cross Country Cross Country: Schedule Cross Country: Roster Cross Country: News Softball Softball: Schedule Softball: Roster Softball: News Tennis Tennis: Schedule Tennis: Roster Tennis: News Track & Field Track & Field: Schedule Track & Field: Roster Track & Field: News Volleyball Volleyball: Facebook Volleyball: Twitter Volleyball: Instagram Volleyball: Schedule Volleyball: Roster Volleyball: News Athletic Facilities Campus Map Cheerleading Directions EADA Report Mission Statement Quick Facts Staff Directory Tradition Title IX Hall of Fame Sports Medicine Sports Information Athletic Logo Wildcat Ticket Office NCAA Compliance S.A.A.C.
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