![]() 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. The term precertification here means the utilization review process to determine whether the requested service, procedure, prescription drug or medical device meets the company's clinical criteria for coverage.Should the following terms and conditions be acceptable to you, please indicate your agreement and acceptance by selecting the button below labeled "I Accept". 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. 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. He also completed a medical and surgical retina fellowship at the Wilmer Eye Institute at The Johns Hopkins Hospital in Baltimore.Īll the doctors at Retina Specialists hold memberships in a number of professional organizations, including the American Society of Retina Specialists and the American Academy of Ophthalmology.By clicking on “I Accept”, I acknowledge and accept that: ![]() Saavedra completed an internship at Riverside Regional Medical Center in Newport News and an ophthalmology residency at the Cleveland Clinic's Cole Eye Institute. After earning his medical degree at the Medical College of Virginia in Richmond, Dr. Harris, fulfilled ophthalmology residency training at Louisiana State University in New Orleans and a retina fellowship at her alma mater in Texas.Įgbert Saavedra, MD, has practiced at Retina Associates since 2006. She completed her medical degree at The University of Texas at Dallas and an internship at the Mayo Clinic in Jacksonville, Florida. He has practiced at Retina Associates since 1999.Īpril Harris, MD, joined Retina Associates in. Javid completed a retina fellowship at Massachusetts Eye and Ear Infirmary at Harvard Medical School. His experience includes an internship at the Mayo Clinic in Scottsdale, Arizona, and an ophthalmology residency at Tulane University Medical Center in New Orleans. The practice maintains three locations, two in Tucson and one in Green Valley.Ĭameron Javid, MD, who trains medical students and residents as a Clinical Associate Professor of Ophthalmology at the University of Arizona College of Medicine in Tucson, earned his medical degree at the University of Illinois. Retina Associates' board certified ophthalmologists all have trained extensively in the subspecialty. Such maladies include common eye injuries, detachments and tears of the retina, macular degeneration, and tumors. ![]() Retina Associates | One of the Nation's Premier Retinal Subspecialty Groupsįounded in 1974, Retina Associates treats disorders and conditions of the retina and the vitreous (the clear gel that fills the eye's interior) for patients in Tucson, Arizona, and surrounding areas.
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