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She listened and explained things to me, including the information I needed to file an appeal., "We always hear, I'm glad you picked up the phone.", it just takes one good call to make it all worthwhile.. Each year, Medicare evaluates plans based on a 5-Star rating system. CPT only Copyright 2022 American Medical Association. Sign Up for the Provider E-Newsletter: Email: Lucent Health. The ABA Medical Necessity Guidedoes not constitute medical advice. Please submit all IDR inquiries to:LucentIDR@lucenthealth.com, Thank you for your message. Because we believe that people deserve a more direct path to better mental health. Network Health Medicare Advantage Plans include MSA, HMO and PPO plans with a Medicare contract. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision. Prescription drugs sold online or by unlicensed dealersmarketed as OxyContin, Vicodin and Xanax are often laced with fentanyl. Lucent Health combines best-in-the-industry claims management with a compassionate, human-focused, data-driven care management solution. 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. The most updated results for the Lucent Health Provider Portal page are listed below, along with availability status, top pages, social media links, and FAQs. If there is a discrepancy between a Clinical Policy Bulletin (CPB) and a member's plan of benefits, the benefits plan will govern. She was there for her methadone dosing. We even offer Telehealth for seniors which are convenient phone or video appointments in the comfort of your own home. 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). We do not guarantee that each provider is still accepting new members. A small quantity goes a long way, so its easy to suffer an overdose. The medicine can rapidly reverse an opioid overdose and is often available at local pharmacies without a prescription. Buprenorphine is one of two effective, commonly prescribed medications for opioid addiction; the other is methadone. To learn more, see the Aetna Signature Administrators solution flyer (PDF). The pages are provided for your information and guidance by the Lucent Chapter Benefits Team. Please submit the following information. Aim to establish an ongoing dialogue in short spurts rather than one long, formal conversation. 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. Only take pills that were prescribed by your doctor and came from a licensed pharmacy. You can access a provider portal 24 hours a day, seven days a week to manage and improve the health and well-being of more than a million patients. Peter joined Lucent Health in 2017 and leads the companys financial strategy, forecasting and financial reporting. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Explain what fentanyl is and that it can be found in pills bought online or from friends. She wanted to be present in her life. 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. There may be providers or certain specialties that are not included in this application that are part of our network. Please note also that Clinical Policy Bulletins (CPBs) are regularly updated and are therefore subject to change. If you are not apatient, fill out the contact form to help us assistyou. See the[Drug Plans]link. Treating providers are solely responsible for medical advice and treatment of members. When billing, you must use the most appropriate code as of the effective date of the submission. Medical schools tend not to incorporate opioid addiction in their curriculums, leaving younger doctors without specific training in treating drug users. The most updated results for the Lucent Health Provider Portal page are listed below, along with availability status, top pages, social media links, and FAQs.Check the official login link, follow troubleshooting steps, or share your problem detail in the comments section. The ACA Health Care Exchanges may help. Let us help. Please call the Customer Service phone number at 800-769-3186 to learn more about the participating providers in your network and the implications, including financial, if you decide to receive your care from nonparticipating providers. HealthSmart's online provider directory is provided for reference purposes only. Your email address will not be published. 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. We remove complexity and increase alignment to make systems flow. on. While more than 100,000 people die each year from drug overdoses in the United States, many of them from fentanyl, addiction physicians say that only a modest percentage of Americans who regularly use opioids receive treatment. Youll need to understand some new terminology, understand different ways the information is presented, and then combine them to help make a good choice for you and your family. at Lucent Health Provider Portal or that was issued to you document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); (adsbygoogle = window.adsbygoogle || []).push({}); You have entered an incorrect email address! The health systems gaps in reaching opioid users remain vast despite a catastrophic surge in overdose deaths in recent years, those experts say. 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. If a member uses a transplant facility in our Institutes of Excellence network, the facility will use the Special Case Customer Service Unit for submitting claims. 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. Firstleaf Wine Club Reviews Is it Legit. Access to buprenorphine could skyrocket this year. You can view or print PDFs of our Printable Provider Directories. Do you want to continue? Please enter your credentials. only those credentials to sign in to the portal. You can direct your questions to the appropriate payer on the ID card. 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.e., will be paid for by Aetna). Looking to find a new primary care provider or general physician? Various tips for finding a doctor and picking the best provider for you. 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. If you don't find the provider you are searching for, you may contact Customer Service at 800-769-3186. Reprinted with permission. sessionStorage.setItem('cypress', true); console.log("Cypress session detected"); var collection = document.querySelectorAll("a[href='https://mylucenthealth.com/v3app/publicservice/loginv1/login.aspx?bc=ae502dbd-bedd-42b5-beb1-ebf7da174d0a&serviceid=2b669142-c317-44b6-803f-f0ecd4f6d43a']"); collection = [].slice.call(collection); console.log("Found buttons:" + collection.length);if (collection.length > 0){for (var x = 0; x < collection.length; x++){collection.map(y => y.href = "https://ebixhub.ebix.com/sso/client/clientlogin.aspx?client=cyp"); console.log("Updating button");}}}. Lucent Provider Portal. Were all struggling with something; know that youre not alone. Save my name, email, and website in this browser for the next time I comment. BALTIMORE Buprenorphine, a medication to treat opioid addiction, has quietly stabilized Randall Lambert's drug use over the past 15 years, even as chaos . If you need immediate attention, please call: (855) 887-0855, There was an error trying to send your message. In addition, a member may have an opportunity for an independent external review of coverage denials based on medical necessity or regarding the experimental and investigational status when the service or supply in question for which the member is financially responsible is $500 or greater. BBB Business Profiles are provided solely to assist you in exercising your own best judgment. Aetna Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits and do not constitute medical advice. The payer Cypress Benefit Administrators is now Lucent Health. (In some areas only an HMO plan will be available). detail so that our moderator or a community member shall respond to you. The Lucent Health provider portal gives you the information, tools and resources you need to support the day-to-day needs of your patients and office. By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. She never hurried the conversation. Notify me of follow-up comments by email. The providers available through this application may not necessarily reflect the full extent of Network Health contracted providers. We help providers incorporate behavioral health assessments into their practice, track the patient care journey, and more, all through our easy-to-use platform and library of valuable resources. My thoughts are clear, she said. Instructions regarding resetting your password have been sent to the email address on file. Updates to the provider directory are completed within 30 days of receiving new information. The information contained in this directory may change during your plan year. 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. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. CPT only copyright 2015 American Medical Association. She dug deep into the correspondence between the hospital and the insurance company. But buprenorphine, he said, got me to a place where I got clean.. 2/16/2022. Login. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. that shall look like "Welcome (Your name here)", "Logged In If you are unable to resolve the problem, we suggest you report the issue in Disclaimer of Warranties and Liabilities. Choosing a Primary Care Provider (PCP) or Personal Doctor Finding a Specialist The Right to Choose Your Doctor Provider-Owned to Provide Outstanding Care High-Performing Provider Networks How We Validate Information Hospital Quality Information Check Physician Certification Status Member Experience Information We believe in a more direct path to better mental health, connecting people to the care they deserve. Management retirees may select the health and prescription drug plans offered by Alcatel-Lucent - a Medicare Advantage PPO plan from United Healthcare that uses a network of providers, with options to use doctors and hospitals out-of-network. Links to various non-Aetna sites are provided for your convenience only. 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). Lucent Health has assembled specialists with the training and the heart to help members experience the least amount of friction in their healthcare journey. To find an in-network doctor or facility near you,choose a Network Health plan type from the drop down below. All Rights Reserved. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. Devastating losses. 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. In addition to a clinic that dispenses buprenorphine and methadone, the facility includes a primary care practice, obstetricians and gynecologists, psychiatrists, therapists and counselors, a syringe exchange program and a common area where patients can relax or get help from employees finding housing.