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Aetna prior 2025

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The document is a Prescription Drug Prior Authorization Request Form for Aetna, detailing the process for submitting requests for prior authorization of prescription drugs, including specialty medications. It provides contact information for faxing and online submission, outlines patient and prescriber information required, and specifies conditions under which prior authorization is needed, particularly regarding opioid dependence treatment. Additionally, it includes compliance statements related to civil rights and language services.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the requested drug name and indicate if it is intended to treat opioid dependence. Select 'Yes' or 'No' as applicable.
Fill in the patient information section, including the patient's name, date of birth, address, and contact details.
Complete the prescribing provider information with the prescriber's name, contact details, and NPI number.
Specify whether this is a new request or reauthorization and provide patient diagnosis along with ICD codes.
Detail the drug(s) requested, including strength, route, frequency, and any additional clinical criteria that support your request.
Finally, ensure all required signatures are included before submitting your form via fax or online through our platform.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (45 Votes)
2016	4.3 Satisfied (57 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.

Whats the difference between a referral and prior authorization?

A referral is an order from your to see a specialist or receive certain medical services from some providers. Your helps make the decision about whether specialist services are necessary for you. Prior authorization is approval from the health plan before you get a service or fill a prescription.

What does a prior authorization mean?

Prior authorization is used by health plans to ensure that only medical care that a plan has determined is necessary, effective, and cost-efficient is provided to its members, and that contraindicated care is not utilized.

What happens if you dont get preauthorization?

Prior authorization is not a guarantee that a claim will be approved, but failure to obtain prior authorization for a service that requires it will generally result in a claim denial. This is true even if the health plan would otherwise have covered the service.

What does it mean to get a prior authorization?

Prior authorization requires your doctor or provider to obtain approval from your health plan before providing health care services or prescribing prescription drugs. Without prior authorization, your health plan may not pay for your treatment or medication.

How long does Aetna take to approve prior authorization?

Aetna will keep your provider updated on how the review is going. If your prior authorization is approved, you should find out within 14 days.

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What is a prior authorization for Aetna?

What is the main difference between the HMO-EPO plan and the PPO plan? The HMO-EPO plan only provides in-network coverage for services, except for urgent and emergent care which would be covered the same out-of-network as it would in-network. The PPO plan offers both in-network and out-of-network coverage.

Aetna prior 2025

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How to use or fill out Aetna Prior Authorization Request Form

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Got questions?

Whats the difference between a referral and prior authorization?

What does a prior authorization mean?

What happens if you dont get preauthorization?

What does it mean to get a prior authorization?

How long does Aetna take to approve prior authorization?

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What is a prior authorization for Aetna?

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