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12/10/2015 Prior Authorization AETNA BETTER HEALTH OF KENTUCKY (MEDICAID) NonFormulary Medications (KY88) This fax machine is located in a secure location as required by HIPAA regulations

12/10/2015 Prior Authorization AETNA BETTER HEALTH OF KENTUCKY (MEDICAID) NonFormulary Medications (KY88) This fax machine is located in a secure location as required by HIPAA regulations-2025

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The document outlines the process for obtaining prior authorization for non-formulary medications under Aetna Better Health of Kentucky's Medicaid program. It includes instructions for completing and submitting the authorization request, necessary patient and physician information, and a series of questions to determine eligibility for coverage. The document emphasizes compliance with HIPAA regulations and provides contact information for inquiries.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Patient Information. Fill in the Patient Name, ID, Group No., DOB, and Phone number accurately.
Next, provide details for the Prescribing Physician. Include the Physician Name, Specialty, NPI Number, Fax, Phone, and Address.
In the Drug Name section, select from the list of drugs provided or specify another if necessary. Fill in Quantity, Frequency, Strength, Route of Administration, and Expected Length of Therapy.
Carefully answer each question regarding previous authorizations and treatment responses by circling 'Yes' or 'No'. Ensure to document any required information for quantity-limit exceptions.
Review all entered information for accuracy before signing. Confirm that you affirm the truthfulness of the information provided.
Finally, fax the signed form to Aetna Better Health of Kentucky at 1-855-799-2550 as instructed.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Does Medicaid use prior authorization?

States have authority over prior authorization practices in Medicaid and can implement prior authorization regulations that are stricter than federal requirements (Medicaid Health Plans of America (MHPA) 2023). Medicaid statute provides authority for utilization review in Medicaid ( 1902(a)(30) of the Act).

Does Medicare require prior authorization?

Provider Service Numbers Automated Voice Response800-807-1301 Prior Authorization Fax 800-807-7840 Prior Authorization Fax 502-327-9453 Home Health Fax 800-664-574911 more rows

Does Kentucky Medicaid require prior authorization?

Note: Prior authorization is not required for emergency or urgent care. Out-of-network physicians, facilities and other health care professionals must request prior authorization for all procedures and services, excluding emergent or urgent care.

What is documentation required for Medicaid in Kentucky?

Get ready to apply Before you start, have this info ready: Employer and income information: household monthly income, pay stubs and W-2 forms. Social Security numbers or document numbers for each household member applying. Date of birth for each household member applying for coverage.