#Ambetter medicare virtual counseling code

If you have any questions about Ambetter Value or Ambetter Virtual Access plans, or making referrals, please contact Provider Services at 1-87. Taxonomy 193400000X = “Single Specialty” Online counseling can be beneficial for those with ADHD as it provides a convenient and affordable alternative to in-person counseling with a therapist that is licensed.You can access Teladoc virtual counseling whether you have insurance or not. Taxonomy 261QM1300X = “Clinic/Center: Multi-Specialty” Your Ambetter online member account puts you in control of your health plan.Claims submitted with a generic taxonomy, like the following, may result in a denial if we are unable to match the provider specialty to the service. To ensure your claims process appropriately with these referral requirements, please include the specific taxonomy that reflects your area of specialty when billing. Screening and counseling for alcohol abuse in a primary care setting tobacco use obesity diet and nutrition. Again, for services to be covered, you must have a referral from the member’s PCP. All members at an appropriate age and/or risk status: Counseling and/or screening for: colorectal cancer elevated cholesterol and lipids certain sexually transmitted diseases HIV depression high blood pressure diabetes. Referral status can be viewed via the secure provider portal at. For SpecialistsĪs a specialist, please ensure your Ambetter Value and Virtual Access patients have a PCP referral anytime you provide services. Retroactive referrals are submitted in the same manner as a regular referral, you simply adjust the start date on the referral form to reflect the past date on which the referral was originally made. If you have already directed a member to specialist care without submitting a referral, we ask that you submit a retroactive referral, so that the specialist services rendered are appropriately covered per the member’s benefits. Referrals can easily be submitted via the secure provider portal at. For Primary Care ProvidersĪs a PCP, please ensure you are submitting referrals anytime an Ambetter Value or Virtual Access member requires care beyond your scope. The only exclusions from this requirement are emergency or urgent care services, as well as in-network mental or behavioral health services, and obstetrical or gynecological services.

New Ambetter from Arizona Complete Health Members Set up your Online. For services to be covered, they must be provided by or referred by a PCP. Certified Application Counselors If you have questions regarding the expansion or. PCPs coordinate our members’ medical care, as appropriate, either by providing treatment or by issuing referrals to other in-network providers. These plans feature a Primary Care Provider (PCP)-centric approach to care delivery. As you begin to see Ambetter Value or Virtual Access members, we want to share an important reminder about billing for services: Ambetter Value and Virtual Access Referral Requirements To create a more streamlined healthcare journey for Ambetter from Superior HealthPlan members, Ambetter created the Ambetter Value and Ambetter Virtual Access plans.

#Ambetter medicare virtual counseling code

Use your ZIP Code to find your personal plan.įind and enroll in a plan that's right for you.įind everything you need in the member online accountĪmbetter Value & Virtual Access Referral Requirement Reminder