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Click ‘Get Form’ to open the Texas Standard Prior Authorization Request Form for Health Care Services in the editor.
Begin with Section 1, Submission. Enter the name of the issuer you are submitting the request to, along with their phone and fax numbers. Make sure to include the date of submission.
In Section 2, General Information, select whether your request is urgent or non-urgent. If urgent, provide a brief clinical reason for urgency.
Proceed to Section 3, Patient Information. Fill in all required fields including patient name, subscriber name (if different), date of birth, and member ID number.
In Section 4, Provider Information, enter details for both the requesting provider and service provider. Ensure that NPI numbers and contact information are accurate.
Section 5 requires you to specify services requested along with relevant codes (CPT, ICD). Provide detailed descriptions and attach any necessary documentation in Section 6.
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Contact the Customer Care Center at 1-877-9-SEE-AETNA (1-877-973-3238).
What number is 800 624 0756?
National Medicare Dentist Line: Have a question? Call the National Medicare Dentist Line at 1-800-624-0756.
What is the Aetna customer service number in the USA?
If your member ID card is lost or damaged, dont worry. To get a replacement, you can call us at 1-877-350-2217 (TTY: 711) or visit your Aetna member website.
Is Aetna based in the US?
Aetna is a healthcare benefits company based in the United States. The organization offers a variety of insurance plans including health insurance, prescription drug coverage, dental plans, group life insurance, and disability coverage.
What number is 866 235 5660?
Call us: 1-866-235-5660 (TTY: 711), An Aetna representative will answer your call.
People also ask
Why am I getting calls from Aetna?
General question? Call our corporate contact center at 1-800-US-AETNA (1-800-872-3862) (TTY: 711). They dont have member account info, but they can share contact options for Aetna Member Services.
Does Aetna have a USA customer service number?
Our provider support teams are ready to help you find the info you need. Get help with benefits, claims, appeals, contracted rates and more. For Aetna Signature Administrators, Meritain Health, mental health services and substance abuse treatment: Call the number on your patients member ID card.
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