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Some care will require your doctor to get our approval first. This process is called prior authorization or preapproval. It means that Aetna Better Health of California agrees that the care is necessary for your health.
Typically, within 5-10 business days of receiving the prior authorization request, your insurance company will either: Approve your request. Deny your request. Ask for more information.
Prior authorization (also called preauthorization and precertification) refers to a requirement by health plans for patients to obtain approval of a health care service or medication before the care is provided. This allows the plan to evaluate whether care is medically necessary and otherwise covered.
Prior authorizations are required by insurance companies for some medications. This includes those that may have less expensive alternatives. The prior authorization process usually takes about 2 days.
How do I get a prior authorization? If your health care provider is in-network, they will start the prior authorization process. If you dont use a health care provider in your plans network, then you are responsible for obtaining the prior authorization.
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People also ask

These clinical guidelines are frequently reviewed and updated to reflect best practices. Your health care provider will communicate with us directly, and generally within 14 days or less, you and your physician will be notified of a decision.
What is prior authorization? This means we need to review some medications before your plan will cover them. We want to know if the medication is medically necessary and appropriate for your situation. If you dont get prior authorization, a medication may cost you more, or we may not cover it.
Where can I check the status of a prior authorization request? To check the status of your prior authorization request, log in to your member website or use the Aetna Health app. You can download the Aetna Health℠ app on the App Store (Apple devices) or Google Play (Android devices).
The review process can take up to two weeks.
A prior authorization is a request submitted on your behalf by your health care provider for a particular procedure, test, treatment, or prescription. It is sometimes known as precertification or preapproval.

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