Plan Facts & Features
PCPs like Aetna’s depression program
The Aetna Depression Management Program provides primary care physicians (PCPs) with a one-stop resource to help diagnose and treat your Aetna patients with depression age 19 years and older.
This program promotes collaboration among PCPs, mental health professionals and Aetna’s care management team. Its focus is on proactive assessment and early intervention, with the goals of improving patients’ quality of life and treatment outcomes.
What the program offers Reimbursement for depression screenings using billing combination V79.0/99420 n
n Assistance with behavioral health referrals
The option to refer eligible patients to Aetna’s Depression in Primary Care program by telephone
We’ve received a good deal of positive feedback from PCPs about the program. For example, Dr. Thomas Giesecke, a Washington state PCP, said: “Depression is an easily overlooked concomitant or underlying diagnosis in patients,
particularly those with multiple complaints or medical problems.”
It’s “easy and standardized” Dr. Giesecke described the ease of using the PHQ-9 form for diagnosis and follow-up of depression prior to starting t h e p r o g r a m . H e a l s o p r a i s e d t h e p r o g r a m ’ telephonic patient support and physician feedback components. “The paperwork process is easy and standardized,” he said. s
To learn more, visit www.aetnadepressionmanagement.com or email us at email@example.com.
Help for patients with alcohol abuse issues
The Aetna Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Program is designed to help primary care physicians screen for alcohol abuse, providing brief intervention and referring individuals to treatment.
The program incorporates the evidence- based protocol established by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). It is open to participating PCPs treating any Aetna medical plan member age 18 years and older.
Program reimbursement The initial screening and brief intervention service is eligible for payment for members enrolled in Aetna commercial (not Medicare) plans for whom your office does not receive primary care capitation payments. PCP offices can bill for each screen by submitting CPT codes 99408 or 99409.
Getting started Follow the steps in the NIAAA Helping Patients Who Drink Too Much Clinician’s Guide, 2005 edition, at: n
http://pubs.niaaa.nih.gov/publications/ Practitioner/CliniciansGuide2005/ clinicians_guide.htm.
For more program details, contact Aetna Behavioral Health at 1-800-424-4660.
n You can also visit the Behavioral Health page of our secure provider website via NaviNet. From the Aetna Plan Central home page choose “Aetna Support Center,” then “Doing Business With Aetna,” “Aetna Benefits Products” and “Behavioral Health.”
New names for our Medicare Advantage plans Most of our Aetna Medicare Advantage (MA) plans will have new names effective January 1, 2010.
The new names will include a plan label such as (HMO), as this information is now required by the Centers for Medicare & Medicaid Services (CMS). We are also removing the words “Golden” and “Golden Choice” from our plan names. For example, the Aetna Golden ChoiceTM Plan will now be called the Aetna MedicareSM Plan (PPO).
Listed below are a few samples of the names that will be used for our MA plans beginning on January 1, 2010. You may need to update your billing systems with the new MA plan names.
2009 MA Plan Name Aetna Golden Medicare Plan® Aetna Golden Choice Plan Aetna Medicare Open Plan
MA Product Type HMO LPPO PFFS
New 2010 MA Plan Name Aetna MedicareSM Plan (HMO) Aetna Medicare Plan (PPO) Aetna Medicare OpenSM Plan (PFFS)