A doctor’s referral is not needed, and individuals getting tested do not need to be a Cedars-Sinai patient prior to booking their testing appointment. 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.With the novel coronavirus spreading rapidly through Los Angeles, Cedars-Sinai has launched a new option for COVID-19 testing by appointment at its urgent care locations, with results available within 48-72 hours. 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. Available at: Accessed: January 23, 2019īy clicking on “I Accept”, I acknowledge and accept that: 2017 Benchmarking Report Summary, Headlines on Growth. Available at: Accessed: January 23, 2019.Ģ Urgent Care Association.
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For more information about Aetna plans, refer to .ġ Weinick, Robin M et al. Information is believed to be accurate as of the production date however, it is subject to change. This message is for informational purposes only, is not medical advice and is not intended to be a substitute for proper medical care provided by a physician. In case of emergency, call 911 or your local emergency hotline or go directly to an emergency care facility. Call our toll-free 24/7 Nurse Line at 1-80 (TDD/TTY: 711) to get more information about where you can seek treatment. If you still aren’t sure where to go, there are resources that can help.
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So they can have you feeling better in no time. Most neighborhood walk-in clinics are open seven days a week and are typically staffed by certified nurse practitioners and physician assistants. For issues like a sore throat, the flu or allergies, a walk-in clinic is usually a good choice. And you’re more likely to be treated faster at urgent care ― 90% of patients are out in less than an hour 2.īut urgent care isn’t the only option when you’re seeking immediate treatment. Urgent care can treat issues like sprains, fractures and cuts that require stitches. In fact, as many as one in four ER visits could be handled at an urgent care center 1. But many health problems can be addressed in other settings. The ER is best equipped to see people with unexpected, intense and immediate symptoms or injuries, such as chest pain, difficulty breathing or severe bleeding.
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The most important thing to consider is the type of treatment you may need. The difference between walk-in clinics, urgent care and the ER