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Aetna providers follow prior authorization guidelines. If you need help understanding any of these guidelines, please call Member Services at 1-855-463-0933 (TTY: 711), 8 AM to 8 PM, seven days a week. Some outpatient services and planned hospital admissions need prior authorization before the service can be covered.
The cost for intravitreal solution (40 mg/mL) is around $1,958 for a supply of 0.05 milliliters, depending on the pharmacy you visit.Intravitreal Solution. QuantityPer unitPrice0.05 milliliters$39,151.00$1,957.55
For billing purposes, use CPT 67028 to report the intravitreal injection and C9291 or J3590 to report the supply of ; the former HCPCS code applies to facilities, while the latter code applies to physicians offices.
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.
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

The prior authorization process begins when a service prescribed by a patients physician is not covered by their health insurance plan. Communication between the physicians office and the insurance company is necessary to handle the prior authorization.
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).
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.
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.
The review process can take up to two weeks.

aetna medication precertification request form