GR 68722 Medication Precertification Form - Aetna 2025

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The document is a precertification request form for Benlysta® (belimumab) injectable medication, intended for patients with systemic lupus erythematosus (SLE). It requires detailed patient, insurance, prescriber, and clinical information to assess eligibility for treatment. The form includes sections for treatment initiation or continuation, diagnosis codes, and specific clinical criteria that must be met for approval.

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2020	4.8 Satisfied (91 Votes)
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2020	4.4 Satisfied (215 Votes)
2013	4.4 Satisfied (61 Votes)

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

What is the number for 1 800 353 1232?

For credentialing questions, call the Aetna credentialing and application management team at 1-800-353-1232 (TTY: 711). Send dental network inquiries to Aetna Dental West, 21215 Burbank Blvd., Suite 620, Woodland Hills, CA 91367 or fax to 1-866-445-4387.

What is the fax number for Aetna precert?

Medical records can be uploaded directly through Aetnas provider portal on Availity or sent to Aetna by fax to 1-833-596-0339.

What is the phone number for Aetna specialty pharmacy?

Our nurses and pharmacists give you the extra support you may need. And our staff knows how to properly ship and handle special medicine to get it to you when you need it. Just call us toll-free at 1-866-782-ASRX (1-866-782- 2779) (TTY: 711).

How do I call Aetna prior authorization?

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?

How to get prior authorization for medication Aetna?

To get prior authorization, your doctor must first submit a request for a specific procedure, test or prescription. They will look at your overall health or any chronic conditions to make that decision. Then theyll share the request with Aetna.

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