Aetna surgery precertification form 2025

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The prior-authorization requirement ended July 1, 2022, for all patientsexcept Medicare Advantage in Georgia and Floridaa year after the AOA and other groups decried Aetnas decision.
Medical records can be uploaded directly through Aetnas provider portal on Availity or sent to Aetna by fax to 1-833-596-0339.
You can submit claims online or resubmissions through ConnectCenter.
Aetna has contracted with eviCore healthcare, an independent specialty medical benefits management company, to administer prior authorization for Enhanced Clinical Review program.
Many gender affirming surgical procedures are considered medically necessary and covered by your plan. Our Gender-Affirming Surgery Clinical Policy Bulletin (CPB) outlines the and genital gender affirming procedures that are considered medically necessary.
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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.
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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