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Aetna Health Insurance | 45 Questions and Answers 100% Correct | Updated 2024
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Aetna Health Insurance | 45 Questions and Answers 100% Correct | Updated 2024
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Aetna Health Insurance | 45 Questions andAnswers 100% Correct | Updated 2024
ECR Program - ANSWER Preauthorization vendors that do authorizations for
some procedures. Gives preauthorization for medical necessity, steers mms to
preferred par providers and includes ambulatory surgery centers due to expansion
of the cardiac rhythm implantable program.
What is the turnaround time for making and keeping a commitment (health
concierge model)? - ANSWER Finish all commitments within 3 - 5 business
days. Some commitments may need more time. In general, take care of all
commitments within 10 business days
When do we cover paternity testing? - ANSWER does not cover paternity
testing to determine a child's father.
What is the definition of open enrollment? - ANSWER a period during which
one may freely enroll in or change one's selection of a health insurance plan or
other benefit program that is ordinarily subject to restrictions.
Are Aetna members charged for the release of X-Rays from radiology and
pathology labs - ANSWER Aetna members may not be charged for copies of X-
rays nor may deposits be required for the release of X-ray filmsAnswer: Yes, the
ambulance provider is entitled to be paid when the ambulance service provides
emergency treatment at the scene.
What information should be emailed to MPPS (Medical Policy & Program Support)
for a gender edit request - ANSWER Member's identification (ID) number
Aetna Student Health ID (when it applies)
, Member's name
Patients' transgender identification (female-to-male transgender, gender fluid,
male-to-female transgender or nonbinary)
What services are included as part of a routine physical exam? - ANSWER
Associated laboratory and radiology services done with this exam
Check of the body for likely signs or symptoms of a medical condition
Discussion of the exam results with the patient or, in the case of a dependent
child, the parent or guardian
Eye exams if done in the Primary Care Physician (PCP) office
Materials for and the administration of immunizations of infectious disease
Review of written record of the patient's medical history followed by an
examination of the symptoms
e.Policies - ANSWER an application that offers access to coverage policy and
procedural content for the different departments within the Aetna Services
Organization
HSA - ANSWER This is an account added on to a medical plan that the member
can take with them when they switch jobs and they can continue to use the
money from the account for qualified medical expenses
1. All the following provider types can be selected as a PCP EXCEPT:
a. Internist
b. Surgeon
c. Family Practitioner
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