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How to use or fill out Aetna Precertification Form with DocHub
- Click ‘Get Form’ to open the Aetna Precertification Form in our editor.
- Begin by filling out the patient information section. Enter the patient's first name, last name, date of birth, and contact details. Ensure all fields are legible.
- In the insurance information section, provide details about the patient's insurance coverage, including member ID and group number if applicable.
- Complete the prescriber information section with the prescriber's name, contact details, and specialty. This is crucial for processing the precertification request.
- Fill out the dispensing provider/administration information. Specify where the medication will be administered and provide relevant contact details.
- In the product information section, indicate the requested medication (Aflibercept) along with dosage and directions for use.
- Provide diagnosis information by entering primary and any additional ICD codes as required.
- Complete clinical information by answering all questions regarding treatment history and patient responses to previous medications.
- Finally, ensure that all sections are completed before signing and dating at the acknowledgment section to finalize your request.
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Contact us
What is the phone number for Medicare prior authorization?
Call us at 1-800-MEDICARE (1-800-633-4227). Help from Medicare is available 24 hours a day, 7 days a week, except some federal holidays. TTY users can call 1-877-486-2048. Contact your local State Health Insurance Assistance Program (SHIP) Get free personalized health insurance counseling.
What number is 1-800-624-0756?
National Medicare Dentist Line: Have a question? Call the National Medicare Dentist Line at 1-800-624-0756.
What is the number for Aetna preauthorization?
For more help understanding what you need prior authorization for, call the Member Services number on your member ID card, 1-833-570-6670 (TTY: 711). Were available between 8 AM and 8 PM, 7 days a week. Are you happy with your Aetna plan?
What is the process for precertification?
Please call the appropriate number below and select the option for precertification: 1-888-MD-AETNA (1-888-632-3862) (TTY: 711) for calls related to indemnity and PPO-based benefits plans. 1-800-624-0756 (TTY: 711) for calls related to HMO-based benefits plans.
How do I submit precertification to Aetna?
Please submit your request electronically through Availity at .availity.com or call 888-632-3862 or 1-800-624-0756 to initiate precertification.
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People also ask
What is the phone number for Aetna Medicare precertification?
Once Aetna receives the signed contract, it will request that the credentialing process get started. The process typically takes 60 to 90 days. For most states, Aetna uses CAQH to obtain credentialing applications. Once approved in the credentialing process, Aetna will countersign and return the final contract.