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Click ‘Get Form’ to open the Aetna Precertification Form in our editor.
Begin by filling out the 'Start of treatment' and 'Continuation of therapy' dates. Ensure these fields are clear and legible.
In section A, provide complete patient information including first name, last name, address, phone numbers, date of birth, allergies, current weight, and height.
Move to section B for insurance details. Enter the Aetna Member ID, Group number, and any other coverage information if applicable.
Complete section C with prescriber information including their name, contact details, and specialty.
In section D, specify the dispensing provider or administration information. Choose the place of administration and provide necessary contact details.
Fill out section E with product information by selecting the requested medication from the list provided.
Section F requires diagnosis information; ensure you indicate primary and secondary ICD-9 codes accurately.
Finally, complete section G with clinical information relevant to the precertification request. Make sure all required questions are answered thoroughly.
Sign and date in section H to acknowledge completion before submitting your form for review.
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Prior authorizationsometimes called preauthorization or precertificationis a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
How do I submit precertification to Aetna?
Please submit your request electronically through Availity at .availity.com or call 888-632-3862 or 1-800-624-0756 to initiate precertification.
What is the process for precertification?
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.
What are the steps for prior authorization?
How To Get Prior Authorization: Step-by-Step Guide Step 1: Check client eligibility. Step 2: Determine if a code or service requires Prior Authorization. Step 3: Find and complete forms. Step 4: Submit a PA request. Step 5: Check the status of an authorization.
What is the phone number for Aetna Medicare precertification?
Once Aetna receives the signed contract, it will request that the credentialing process get started. The process typically takes 60 to 90 days. For most states, Aetna uses CAQH to obtain credentialing applications. Once approved in the credentialing process, Aetna will countersign and return the final contract.
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People also ask
What steps are needed to obtain precertification?
To obtain precertification, one should call the provider services number, provide procedure and diagnosis details to the insurer, and document the call in the patients health record.
How long does insurance precertification take?
It typically takes 24 to 72 hours. You may check the status of your prior authorization request on the prior authorizations page. You may also contact your doctors office directly.
Related links
Procedures, programs and drugs that require precertification
Providers can use the drug-specific SpecialtyMedication Request Form located online under Specialty. PharmacyPrecertification. . Providers can submit
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